Medicare

Sign up for Medicare Part B Online, by Fax or Mail

August 6, 2020 • By

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 if:

  1. You are already enrolled in Medicare Part A.
  2. 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]) and CMS-L564 (Request for Employment Information) online.

You can also fax the CMS-40B and CMS-L564 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.  

 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 GHP or LGHP.
    • 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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About the Author

Darlynda Bogle, Assistant Deputy Commissioner

Darlynda Bogle, Assistant Deputy Commissioner

Darlynda Bogle, Assistant Deputy Commissioner

Comments

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  1. Shahrear Polash

    Hi I was trying to reactivate my Dad’s Medicare part B plan as we have already paid the premium. So we have downloaded and completed the SSA-795 as told by one of the SSA representative. So we were looking for the fax number to fax the papers. So can I please get the fax number for the SSA office the one with is located in 1380 Parker Street, Bronx, NY-10462

    Reply
    • Robert C. Thompson

      Me too. Where is the Secure (against fraud) fax phone number for submitting form SSA-1696 ?

      Reply
      • Vonda

        Hi Robert, thanks for using our blog. Call your local Social Security office. Please look for the general inquiry telephone number at the Social Security Office Locator. The number may appear under Show Additional Office Information. Please be aware that our call wait times are longer than normal. We hope this information helps.

        Reply
    • Vonda

      Hi Shahrear, thanks for using our blog. Use our Social Security Office Locator to obtain your local office fax number. We hope this helps!

      Reply

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