Social Security Part B Enrollment Form

You can also fax the cms 40b and cms l564 to 1 833 914 2016.

Social security part b enrollment form.

Or contact your local social security office. Fax them to 1 833 914 2016. If you already have part a and want to sign up for part b complete an application for enrollment in part b cms 40b. Or return forms by mail to your local social security office.

1395o 1395s and 1395ii for your enrollment in medicare part b. You will need to sign up for it during your initial enrollment period or you will pay a penalty. There s 3 ways you can sign up. If you don t already have part a you can apply online at ssa gov benefits medicare.

To sign up please call our toll free number at 1 800 772 1213 tty 1 800 325 0778 you also may contact your local social security office. State i want part b coverage to begin mm yy in the remarks section of the cms 40b form or the online application. Please call us at 1 800 772 1213 tty 1 800 325 0778 monday through friday between 8 a m. If you live in puerto rico you will not receive medicare part b medical insurance automatically.

Call social security at 1 800 772 1213 tty. Tty users can call 1 800 325 0778. Social security is authorized to collect your information under sections 1836 1840 and 1872 of the social security act as amended 42 u s c. Signing up for part b is easy apply by march 31.

If you worked for a railroad call the rrb at 1 877 772 5772. You can also fax your enrollment forms and evidence of employment to 1 833 914 2016. Your employer doesn t need to sign section b of the cms l564 form. Call social security at 1 800 772 1213.

The form you are looking for is not available online. Fill out a short form and send it to your local social security office. If you get benefits from the railroad retirement board contact your local. You may complete the forms online by visiting the apply for medicare part b online during a special enrollment period webpage.

Please contact social security at 1 800 772 1213 tty 1 800 325. Many forms must be completed only by a social security representative. Visit faq ssa gov or call social security to free at 1 800 772 1213 tty 1 800 325 0778 for more information. Or return the forms by mail to your local social security office.

If you have questions please contact social security at 1 800 772 1213 tty 1 800 325 0778. When do i sign up. Social security is authorized to collect your information under sections 1836 1840 and 1872 of the social security act as amended 42 u s c. Get this form and instructions in spanish.

1395o 1395s and 1395ii for your enrollment in medicare part b. Social security and the centers for medicare medicaid services cms need your information to determine if you.