Medicare Enrollment Application Form, Contact Social Security to apply for Medicare for the first time.

Medicare Enrollment Application Form, You can use this form to sign up for Part B during these times: If you don’t have Part A, don’t complete this application. Jun 5, 2026 · You can enroll in Medicare by filling out these forms electronically using PECOS on the CMS website. Fill out the Application for Enrollment in Medicare Part B (Medical Insurance) (CMS-40B) (PDF). Learn how to enroll in Medicare Parts A and B, or Part A only, through Social Security online or by phone. If you are applying during the Special Enrollment Period, also fill out the Request for Employment Information (CMS-L564) (PDF). Use this form if you already have Medicare Part A and want to sign up for Part B (Medical Insurance). Get the forms you need to sign up for Part B including CMS-40B, CMS-L564, CMS-10797, and CMS-10798. Contact Social Security to apply for Medicare for the first time. All physicians, as well as all eligible professionals as defined in section 1848(k)(3)(B) of the Social Security Act must complete this application to enroll in the Medicare program and receive a Medicare billing number. . 2dnmnhjd3, nivonk, ly, npq, cqih, g113, f4iw5, tovyo, 4k, odszc,