Social Security Medicare Part A Application Form

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If you do not live in the u s.

Social security medicare part a application form.

If you have questions please contact social security at 1 800 772 1213 tty 1 800 325 0778. Or return the forms by mail to your local social security office. If you don t already have part a you can apply online at ssa gov benefits medicare. Or by calling our national toll free service at 1 800 772 1213 tty 1 800 325 0778 or visiting your local social security office.

You can complete an application for retirement spouse s medicare or disability benefits online. Or contact your local social security office. Your iep lasts for 7 months. An appointment is not.

It begins 3 months before your 65th birthday or 25th month of disability and ends 3 months after you reach 65 or 3 months. You may complete the forms online by visiting the apply for medicare part b online during a special enrollment period webpage. 1395o 1395s and 1395ii for your enrollment in medicare part b. If you are applying for medicare part b due to a loss of employment or group health coverage you will also need to complete form cms l564 request for employment.

Please call us at 1 800 772 1213 tty 1 800 325 0778 monday through friday between 8 a m. You can also fax your enrollment forms and evidence of employment to 1 833 914 2016. Medicare part a hospital insurance helps pay for inpatient care in a hospital or limited time at a skilled nursing facility following a hospital stay. Get this form and instructions in spanish.

Visit your local social security office. Call ahead to make an appointment. If you do not wish to use the online application or the application for the benefit you want is not available online you can. Contact social security if you want to apply for medicare for the first time.

You can help by being ready to provide the information and. If you worked for a railroad call the rrb at 1 877 772 5772. Or one of its territories you can also contact your nearest u s. Call us at 1 800 772 1213 tty 1 800 325 0778.

Medicare at any age. The form you are looking for is not available online. Social security is authorized to collect your information under sections 1836 1840 and 1872 of the social security act as amended 42 u s c. Part a also pays for some home health care and hospice care.

If you already have part a and want to sign up for part b complete an application for enrollment in part b cms 40b. Many forms must be completed only by a social security representative. Social security office u s. Visit your local social security office.

If you do not have part a do not complete this form. Visit faq ssa gov or call social security toll free at 1 800 772 1213 for more information. Social security enrolls you in original medicare part a and part b.

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