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Enrolling into Medicare Part B during COVID - Medicare Part B Online Enrollment
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Enrolling into Medicare Part B during COVID
Already Enrolled in Medicare
If you already have Medicare, you can get information and services online. Find out how to manage your benefits.
If you are already enrolled in Medicare Part A and you want to enroll in Part B, please complete form CMS-40B, Application for Enrollment in Medicare – Part B (medical insurance). If you are applying for Medicare Part B due to a loss of employment or group health coverage, you will also need to complete form CMS-L564, Request for Employment Information.
You have three options to submit your enrollment request under the Special Enrollment Period. You can do one of the following:
Go to “Apply Online for Medicare Part B During a Special Enrollment Period” and complete CMS-40B and CMS-L564. Then upload your evidence of Group Health Plan or Large Group Health Plan.
Fax your forms to 1-833-914-2016.
Mail your CMS-40B, CMS-L564, and evidence to your local Social Security field office.
Note: When completing the CMS-L564:
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 as you can on behalf of your employer without your employer’s signature.
Also submit one of the following forms of secondary evidence:
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.
For more information on your options, please call: 1-855-368-4717 or visit one of our pages:
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