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medicare part b form

You use the Medicare Part B form (CMS-40B) when you already have Part A and want to sign up for Part B medical insurance, and you can download and submit it through Social Security or Medicare channels.

What is the Medicare Part B form?

  • The main Medicare Part B form is called “Request for Enrollment in Medicare Part B (Medical Insurance)” – CMS-40B.
  • It is used when you already have Medicare Part A but need to enroll in Part B for doctor visits, outpatient services, and other medical coverage.

When do you use this form?

  • During your Initial Enrollment Period (around when you turn 65 or first become eligible for Medicare).
  • During the General Enrollment Period (January 1–March 31 each year) or in certain Special Enrollment Period situations tied to employer coverage.

Where to get the Medicare Part B form

  • You can download the current CMS-40B directly from official Medicare/CMS pages in PDF format.
  • Medicare’s “Forms” or “Enrollment forms” pages list Part B enrollment forms and related documents like CMS-L564 (Request for Employment Information) if you are enrolling using employer coverage.

Key sections of the form

  • Basic information: Medicare number, name, and mailing address.
  • Questions on current work/coverage: Including international volunteer or employer coverage details when applicable.
  • Signature and date: You must sign and date; a witness section is included if you sign with a mark instead of a signature.

How to submit the Medicare Part B form

  • You typically mail or fax the completed CMS-40B to your local Social Security office , whose contact information can be found via the Social Security “office locator.”
  • In many cases, you may also handle Part B enrollment or upload supporting forms through online Social Security/Medicare portals , especially for Special Enrollment Periods.
[9][5] [1][9]
Form What it’s called What it’s used for
CMS-40B Request for Enrollment in Medicare Part B Sign up for Part B when you already have Part A.
CMS-L564 Request for Employment Information Provide proof of employer coverage to qualify for a Part B Special Enrollment Period.
**TL;DR:** If you are searching for the **Medicare Part B form** , you almost always need **CMS-40B** , which you download from official Medicare or Social Security sites, fill out with your Medicare and contact details, and then send (often with CMS-L564 if using employer coverage) to your local Social Security office.

Information gathered from public forums or data available on the internet and portrayed here.