What this form is for
Application for Enrollment in Medicare Part B (CMS-40B). Applies for Medicare Part B when you did not take it at 65.
Who needs it
People enrolling during a special enrolment period, usually after employer cover ends.
When you do not need it
If you are already receiving Social Security when you turn 65, Parts A and B start automatically and there is nothing to file.
How to fill it in
Open the file in the Quire editor. Existing form fields become editable straight away; on a flat scan you can drop your own text boxes, checkboxes and dates exactly where they belong. Sign it with the Sign tool — draw, type or upload your signature — then export.
Everything happens in your browser. A tax or immigration form carries enough personal information that it has no business sitting on somebody else's server, and here it never does.
What goes wrong
- A special enrolment period runs eight months from the end of the employment or the group cover, whichever comes first. Miss it and you wait for the general enrolment period and pay a permanent late penalty.
Where it goes
Submit it to the address or online portal named in the agency’s current instructions. Sending an application to a superseded address is one of the most common causes of delay.
This page explains the document and helps you fill it in. It is not legal or tax advice, and it is not affiliated with any government agency.