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Versions Form popularity Fillable & printable
2020 4.8 Satisfied (76 Votes)
2010 4.4 Satisfied (570 Votes)
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Centers for Medicare Medicaid Services.
Fill out Form CMS-40B (Application for Enrollment in Medicare Part B). Send the completed form to your local Social Security office by fax or mail. Call 1-800-772-1213.
Best Medicare Advantage Plans of 2023 Best Overall: AARP / UnitedHealthcare. Best Overall, Runner up: Aetna. High Medicare Star Ratings: Blue Cross Blue Shield. Great for Nationwide Coverage: Humana. Best for Customer Satisfaction: Kaiser Permanente. Lowest Cost: Cigna.
The Centers for Medicare Medicaid Services (CMS) is a Federal agency within the U.S. Department of Health and Human Services. Many CMS program related forms are available in Portable Document Format (pdf).
CMS 40B. Form Title. Application for Enrollment in Medicare - Part B (Medical Insurance) Revision Date. 2021-07-31.
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People also ask

You can complete the Part B SEP online or you can mail your completed CMS 40B, Application for Enrollment in Medicare - Part B (Medical Insurance) and CMS L564 - Request for Employment Information to your local Social Security office.
Medicare Part B Premium and Deductible The standard monthly premium for Medicare Part B enrollees will be $164.90 for 2023, a decrease of $5.20 from $170.10 in 2022.
Centers for Medicare Medicaid Services Information - Health Facilities | Texas Health and Human Services. The .
This form is used for proof of group health care coverage based on current employment. This information is needed to process your Medicare enrollment application. The employer that provides the group health plan coverage completes the information about your health care coverage and dates of employment.
Medicare Supplement Plan G is the best overall plan that provides the most coverage for seniors and Medicare enrollees. Plan G will cover almost everything except the Medicare Part B deductible, which is only $226 for 2023.

cms form 20027