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Versions Form popularity Fillable & printable
CMS-40B 2021 4.8 Satisfied (113 Votes)
CMS-40B 2019 4.2 Satisfied (66 Votes)
CMS-40B 2018 4.3 Satisfied (204 Votes)
CMS-40B 2017 4.1 Satisfied (58 Votes)
CMS-40B 1990 4.3 Satisfied (43 Votes)
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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. TTY users can call 1-800-325-0778.
You need to get the completed form from your employer and include it with your Application for Enrollment in Medicare (CMS-40B). Then you send both together to your local Social Security office. Find your local office here: www.ssa.gov.
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.
CMS 40B. Form Title. Application for Enrollment in Medicare - Part B (Medical Insurance) Revision Date.
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