You can sign up for Medicare Part B online! If you’re enrolled in Medicare Part A and want to enroll in Part B during the Special Enrollment Period, please visit our Medicare web page at www.ssa.gov/benefits/medicare/.
From there, you can enroll in Part B by completing these forms: CMS-40B (Application for Enrollment in Medicare – Part B [Medical Insurance]) and CMS-L564 (Request for Employment Information).
You can also fax or mail the CMS-40B and CMS-L564 to your local Social Security office to enroll. You can find the fax number and address for your local office at www.ssa.gov/locator. Please contact Social Security at 1-800-772-1213 (TTY 1-800-325-0778) if you have any questions.
Note: When completing the forms:
• State, “I want Part B coverage to begin (MM/YY)” in the remarks section of the CMS-40B form or online application.
• If your employer is unable to complete Section B, please complete that portion as best you can on behalf of your employer without your employer’s signature.
• Submit one of the following types of secondary evidence by uploading it from a saved document on your computer:
• Income tax returns that show health insurance premiums paid.
• W-2s reflecting pre-tax medical contributions.
• Pay stubs that reflect health insurance premium deductions.
• Health insurance cards with a policy effective date.
• Explanations of benefits paid by the Group Health Plan or Large Group Health Plan.
• Statements or receipts that reflect payment of health insurance premiums.
Please let your friends and loved ones know about this online, mail, or fax option.
Daniel Damceski is the staff assistant/state liaison for central Ohio. You can write him c/o Social Security Administration, 200 N. High St., Columbus OH 43215 or via email at email@example.com.