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Use this form: • If you’re eligible for Social Security benefits but only want to get Medicare. You must at least 64 and 8 months. (You won’t pay a premium for Part A.) • If you’re not eligible for Social Security benefits and want to sign up for Part A. You can sign up only during certain times— see next page. (You’ll pay a premium for Part A.)
Get the forms you need to sign up for Part B including CMS-40B, CMS-L564, CMS-10797, and CMS-10798.
Sign up for Medicare. If you're 65 or older, you can enroll online for Parts A and B, or Part A only. You can delay Part B if you're already covered through an employer group health plan. The application is for retirement benefits and Medicare, or Medicare only. Apply online.
Apply online to sign up for Part B if you already have Part A. Have the employer fill out form CMS-L564. Send the completed form to your local Social Security office by fax or mail. If the employer can’t fill it out, complete Section B of the CMS-L564 form as best you can, but don’t sign it.
Complete this application if you are an individual practitioner or eligible professional who plans to bill Medicare and you are: Currently enrolled in Medicare to order and certify and want to enroll as an individual practitioner to submit claims for services rendered.
Medicare application? You should apply online for Medicare, if you: • Are within three months of turning age 65 or older. • Want Medicare benefits and have not previously applied for Medicare. • Reside in the United States or one of its territories or commonwealths. You can still apply for Medicare online even if you are not ready to ...
Forms. Get Medicare forms for different situations, like filing a claim or appealing a coverage decision. Find Forms. Publications. Read, print, or order free Medicare publications in a variety of formats. Get Publications. Mailings. Find out what to do with Medicare information you get in the mail. Find Mailings.