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What you should know about CMS40B Form

  1. This form is to sign up for medical insurance under Medicare Part B.
  2. You must sign up for Part B using this form.
  3. Form Approved OMB No. 0938-1230 Expires 02/20

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How to prepare CMS40B Form

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About Cms40b 20182019 Form

The CMS-40B form refers to the Application for Enrollment in Medicare. It is a document used to apply for Medicare Part B coverage, which provides medical insurance for services such as doctor visits, outpatient care, and preventive services. The CMS-40B form is typically completed by individuals who are already enrolled in Medicare Part A (hospital insurance) and wish to enroll in Medicare Part B. This form is needed by various individuals, such as: 1. Individuals turning 65: When turning 65, many people become eligible for Medicare and may need to enroll in Medicare Part B by completing the CMS-40B form. 2. Individuals who delayed Medicare Part B: Some individuals choose to delay enrolling in Medicare Part B if they have private health insurance through employment or other means. When they decide to enroll, they need to complete the CMS-40B form. 3. Individuals who want to switch from Part C to Parts A and B: Some individuals who have Medicare Advantage plans (Part C) may later decide to switch back to Original Medicare (Parts A and B). In such cases, they would need to complete the CMS-40B form to enroll in Medicare Part B. 4. Individuals losing group health coverage: When someone is covered by a group health plan and this coverage ends, they may qualify for a Special Enrollment Period to enroll in Medicare Part B. The CMS-40B form is required in such situations. Overall, the CMS-40B form is used by those who need to apply for Medicare Part B coverage or make changes to their existing Medicare coverage. It is important to fill out this form accurately and submit it within the designated time frames to ensure timely enrollment in Medicare Part B.

How to complete a CMS40B Form

  1. If you are signing up in a Special Enrollment Period (SEP), you will also need the Form CMSL564 Request for Employment Information completed by your employer
  2. Make sure you already have Medicare Part A before completing this form
  3. Contact Social Security if you are applying for Medicare for the first time

People also ask about CMS40B Form

What information do you need to complete this application?
You will need Your Medicare Number, Your current address and phone number, Form CMS-L564 Request for Employment Information completed by your employer if you're signing up in a SEP.
How do you get help with this?
Phone Call Social Security at 1-800-772-1213. TTY users should call 1-800-325-0778.
Who can use this application?
People with Medicare who have Part A but not Part B can use this form.

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