Social Security Column Sign up for Medicare Part B online

Erin Thompson, Social Security Public Affairs Specialist, in Toledo

        For many people, signing up for Medicare Part B doesn’t require you to leave the comfort of home.
        Please visit our Medicare Part B webpage at if:
        • You’re enrolled in Medicare Part A.
        • You would like to enroll in Part B during the Special Enrollment Period.
        You can complete form CMS-40B (Application for Enrollment in Medicare – Part B [Medical Insurance]) at and CMS-L564 (Request for Employment Information) at
        You can also fax the CMS-40B and CMS-L564 forms to 1-833-914-2016; or return forms by mail to your local Social Security office. Please contact Social Security at 1-800-772-1213 (TTY 1-800-325-0778) if you have any questions.
         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 GHP (Group Health Plan) or LGHP (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.


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