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Social security medicare part b application form.
Call us at 1 800 772 1213 tty 1 800 325 0778.
1395o 1395s and 1395ii.
You can also fax your enrollment forms and evidence of employment to 1 833 914 2016.
You may complete the forms online by visiting the apply for medicare part b online during a special enrollment period webpage.
This information is needed for ssa and the centers for medicare medicaid services cms to determine if you are entitled to supplementary medical insurance part b.
Fax them to 1 833 914 2016.
If you live in puerto rico you will not receive medicare part b medical insurance automatically.
If you worked for a railroad call the rrb at 1 877 772 5772.
Please call us at 1 800 772 1213 tty 1 800 325 0778 monday through friday between 8 a m.
If you don t already have part a you can apply online at ssa gov benefits medicare.
Social security is authorized to collect your information under sections 1836 1840 and 1872 of the social security act as amended 42 u s c.
When do i sign up.
If you already have part a and want to sign up for part b complete an application for enrollment in part b cms 40b.
If you don t already have part a you can apply online at ssa gov benefits medicare.
Visit faq ssa gov or call social security to free at 1 800 772 1213 tty 1 800 325 0778 for more information.
Social security is authorized to collect your information under sections 1836 1840 and 1872 of the social security act as amended 42 u s c.
Visit faq ssa gov or call social security toll free at 1 800 772 1213 for more information.
If you have questions please contact social security at 1 800 772 1213 tty 1 800 325 0778.
Call social security at 1 800 772 1213 tty.
An appointment is not.
The social security act as amended 42 u s c.
The form you are looking for is not available online.
You can complete an application for retirement spouse s medicare or disability benefits online.
Visit your local social security office.
Social security and the centers for medicare medicaid services cms need your information to determine if you.
Or contact your local social security office.
1395o 1395s and 1395ii for your enrollment in medicare part b.
Many forms must be completed only by a social security representative.
1395o 1395s and 1395ii for your enrollment in medicare part b.
You will need to sign up for it during your initial enrollment period or you will pay a penalty.
Or return the forms by mail to your local social security office.