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.
Social security medicare part b application form.
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.
You can complete an application for retirement spouse s medicare or disability benefits online.
To sign up please call our toll free number at 1 800 772 1213 tty 1 800 325 0778 you also may contact your local social security office.
The social security act as amended 42 u s c.
Social security and the centers for medicare medicaid services cms need your information to determine if you.
Or contact your local social security office.
The form you are looking for is not available online.
1395o 1395s and 1395ii.
Or return the forms by mail to your local social security office.
When do i sign up.
Get this form and instructions in spanish.
Call social security at 1 800 772 1213 tty.
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.
If you don t already have part a you can apply online at ssa gov benefits medicare.
Many forms must be completed only by a social security representative.
State i want part b coverage to begin mm yy in the remarks section of the cms 40b form or the online application.
If you have questions please contact social security at 1 800 772 1213 tty 1 800 325 0778.
You will need to sign up for it during your initial enrollment period or you will pay a penalty.
If you don t already have part a you can apply online at ssa gov benefits medicare.
Visit faq ssa gov or call social security toll free at 1 800 772 1213 for more information.
If you already have part a and want to sign up for part b complete an application for enrollment in part b cms 40b.
An appointment is not.
If you live in puerto rico you will not receive medicare part b medical insurance automatically.
Call us at 1 800 772 1213 tty 1 800 325 0778.
Fax them to 1 833 914 2016.
1395o 1395s and 1395ii for your enrollment in medicare part b.
Visit faq ssa gov or call social security to free at 1 800 772 1213 tty 1 800 325 0778 for more information.
Please call us at 1 800 772 1213 tty 1 800 325 0778 monday through friday between 8 a m.
If you worked for a railroad call the rrb at 1 877 772 5772.
Visit your local social security office.