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You can voluntarily terminate your Medicare Part B (Medical Insurance). However, you may need to have a personal interview with Social Security to review the risks of dropping coverage and to assist you with your request.
The way the penalty works is that you pay a 10 percent increase for every 12-month period that you could have had Medicare coverage, but didnt. And, this increase will stay with you forever.
Without Part B, you cant enroll in other parts of Medicare, such as Part D prescription drug coverage, Medicare Supplement (Medigap), or Medicare Advantage. These gaps will remain until you re-enroll in Part B again later.
Although Form CMS 1763 is not available for online submission, you can find it in docHubs library, fill out and easily print it out from your account.
CMS-1763 Request for Termination of Premium Hospital and Supplementary Medical Insurance.
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Although Form CMS 1763 is not available for online submission, you can find it in docHubs library, fill out and easily print it out from your account.
You must submit Form CMS-1763 (PDF, Download docHub Reader) to the Social Security Administration (SSA). Visit or call the SSA (1-800-772-1213) to get this form.
CMS 1763. Form Title. Request for Termination of Premium Hospital Insurance of Supplementary Medical Insurance. Revision Date.
Voluntary Termination of Medicare Part B You must submit Form CMS-1763 (PDF, Download docHub Reader) to the Social Security Administration (SSA). Visit or call the SSA (1-800-772-1213) to get this form. Youll need to have a personal interview with Social Security before you can terminate your Medicare Part B coverage.
You must submit Form CMS-1763 (PDF, Download docHub Reader) to the Social Security Administration (SSA). Visit or call the SSA (1-800-772-1213) to get this form.

cms form 1763