Looking for a Medicare form?

The medicare forms below are a few hand-selected of the most commonly used forms. Several forms listed may not be available online, but can be requested by calling either the Social Security Administration or Centers for Medicare & Medicaid Services (CMS). If you need help finding a form, please give us a call.

These forms can also be found on www.medicare.gov.

CMS-40B

Application for Enrollment in Part B
I have Part A and want to apply for Part B (Application for Enrollment in Part B/CMS-40B).

CMS-L564

Request for Employment Information
I want to sign up for Part B while I’m employed or during the 8 months after employment or my employer/union coverage has ended, and I need to provide employment (Request for Employment Information/CMS-L564).