Form Approved OMB No. 09381230 Expires: 02/21DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICESAPPLICATION FOR ENROLLMENT IN MEDICARE PART B (MEDICAL INSURANCE) WHO CAN.
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How to fill out the CMS-40B online
The CMS-40B is an essential form for individuals looking to enroll in Medicare Part B (Medical Insurance). This guide provides a clear, step-by-step approach to completing the form online, ensuring that users can navigate the process with confidence.
Follow the steps to complete your CMS-40B application online.
- Click ‘Get Form’ button to obtain the CMS-40B application and open it in your preferred editor.
- Your Medicare Number: Write your Medicare number in the designated field.
- Do you wish to sign up for Medicare Part B? Mark ‘YES’ if you want to enroll in Medicare Part B. If you do not wish to sign up, there is no need to fill out the application.
- Your Name: Input your name as it appears on your Social Security or Medicare application, listing your last name, first name, and middle name in that order.
- Mailing Address: Enter your complete mailing address, including the number and street name, P.O. Box if applicable, or route.
- City, State, and ZIP Code: Fill in the city name, state, and ZIP code associated with your mailing address.
- Phone Number: Include your 10-digit phone number, making sure to include the area code.
- Written Signature: Sign your name in the provided space. Do not print; the signature must be handwritten.
- Date Signed: Indicate the date you signed the application.
- If applicable, Signature of Witness: If you signed with an ‘X’, provide a witness signature in the required section.
- Date Signed (by Witness): The witness must also provide the date they signed.
- Address of Witness: If a witness is required, include their address in the designated field.
- Remarks: Use this space for any additional comments or clarifications regarding your application.
- After completing the form, review all entries for accuracy. You can then save changes, download, print, or share the completed CMS-40B application.
Begin filling out your CMS-40B application online today to ensure your timely enrollment in Medicare Part B.
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Can I get help paying for Medicare Part B?
Call 1-800-MEDICARE (1-800-633-4227) and ask about getting help paying for your Medicare premiums. TTY users can call 1-877-486-2048. Call your State Medical Assistance (Medicaid) office.
Can I sign up for Medicare Part B online?
You can enroll in Medicare Part A and/or Medicare Part B in the following ways: Online at www.SocialSecurity.gov. By calling Social Security at 1-800-772-1213 (TTY users 1-800-325-0778), Monday through Friday, from 7AM to 7PM. In-person at your local Social Security office.
How do I apply for Medicare Part B online?
State I want Part B coverage to begin (MM/YY) in the remarks section of the CMS-40B form or online application. If possible, your employer should complete Section B.
Can I apply for Medicare Part B online if I already have Part A?
If you are already enrolled in Medicare Part A and you want to enroll in Part B, please complete form CMS-40B, Application for Enrollment in Medicare Part B (medical insurance). ... Go to Apply Online for Medicare Part B During a Special Enrollment Period and complete CMS-40B and CMS-L564.
Will Medicaid pay for my Medicare Part B premium?
Medicaid can provide premium assistance: In many cases, if you have Medicare and Medicaid, you will automatically be enrolled in a Medicare Savings Program (MSP). MSPs pay your Medicare Part B premium, and may offer additional assistance. ... Note: You cannot be required to enroll in a Medicare Advantage Plan.
What is Form CMS 40b?
Form CMS-40b is a form from the Center for Medicare & Medicaid Services that you use when applying for Medicare part B. Medicare part B is insurance coverage from Medicare that covers things like outpatient care, preventive services and medical equipment.
What is a CMS 40B form?
Form # CMS 40B. Form Title. Application for Enrollment in Medicare - Part B (Medical Insurance)
Is Medicare Part B ever free?
Part B, referred to as medical insurance, is not free. You pay a monthly premium for Medicare Part B. Part B is the portion of Medicare that more closely resembles what you may think of as traditional health insurance.
Where do I send my CMS 40B?
You can also fax the CMS-40B and CMS-L564 to 1-833-914-2016; or return forms by mail to your local Social Security office. Please contact Social Security at 1-800-772-1213 (TTY 1-800-325-0778) if you have any questions.
How do I avoid Medicare Part B premium?
Sign up for Part B on time. ... Defer income to avoid a premium surcharge. ... Pay your premiums directly from your Social Security benefits. ... Get help from a Medicare Savings Program.
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