Form CMS-40b is only for people who are enrolled in Medicare part A already. If you haven’t enrolled in part A yet, you shouldn’t use this form to apply. How to Fill Out Form CMS-40b ...

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).

Form CMS-L564 is an employment information form from the Social Security Administration (SSA). It’s used in conjunction with Form CMS-40B when you apply for Medicare part B during a special ...

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 ...

Have Steve’s human resources department sign off on the CMS-L564 form and attach it to CMS-40B. Under the remarks section on the CMS-40B, write the month when Part B coverage should begin.

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 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 ...