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Last updated: 2/5/2024
Application For Enrollment In Medicare-Part B (Medical Insurance) {CMS-40B}
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Description
CMS-40B - APPLICATION FOR ENROLLMENT IN MEDICARE PART B (MEDICAL INSURANCE). Use this form: • If you’re in your IEP and refused Part B or did not sign up when you applied for Medicare, but now want Part B. • If you want to sign up for Part B during the General Enrollment Period (GEP) from January 1 – March 31 each year. • If you’re eligible for a Special Enrollment Period (SEP). • If you’re in your Initial Enrollment Period (IEP) and live in Puerto Rico. You must sign up for Part B using this form. NOTE: Your IEP lasts for 7 months. It begins 3 months before your 65th birthday (or 25th month of disability) and ends 3 months after you reach 65 (or 3 months after the 25th month of disability). www.FormsWorkflow.com
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