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Send your completed and signed application to your local Social Security office. If you sign up in a SEP, include the CMS-L564 with your Part B application. If you have questions, call Social Security at 1-800-772-1213. TTY users should call 1-800-325-0778.
You can apply online or you can mail your completed CMS 40B, Application for Enrollment in Medicare - Part B (Medical Insurance) to your local Social Security office.
You can complete form CMS-40B (Application for Enrollment in Medicare Part B [Medical Insurance]) and CMS-L564 (Request for Employment Information) online. 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.
Send cms 1763 form via email, link, or fax. You can also download it, export it or print it out. Draw your signature, type it, upload its image, or use your mobile device as a signature pad. Send cms 1763 form via email, link, or fax.
Generally, youre first eligible to sign up for Part A and Part B starting 3 months before you turn 65 and ending 3 months after the month you turn 65. If you sign up for Medicare, stop your Marketplace coverage so it ends when your Medicare coverage starts.
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You can complete form CMS-40B (Application for Enrollment in Medicare Part B [Medical Insurance]) and CMS-L564 (Request for Employment Information) online. 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.
Apply online (at Social Security) This is the easiest and fastest way to sign up and get any financial help you qualify for. Youll create your secure my Social Security account to sign up for Medicare or apply for Social Security benefits online.
Fill out the Application for Enrollment in Medicare Part B (CMS-40B) (PDF). If you are applying during the Special Enrollment Period, also fill out the Request for Employment Information (CMS-L564) (PDF).

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