For many people, signing up for Medicare Part B doesn’t require you to leave the comfort of home.  Visit our Medicare Part B webpage at secure.ssa.gov/acu/ophandler/loginSuccess if:

• You’re enrolled in Medicare Part A.

• You would like to enroll in Part B during the Special Enrollment Period. What is a Special Enrollment Period? If you didn’t sign up for Part B when you turned 65 because you had medical insurance coverage under a group health plan based on your or your spouse's current employment, you may qualify for a "Special Enrollment Period" (SEP). This allows you to sign up for Part B during any month you remain covered under the group health plan and your, or your spouse's, employment continues OR in the 8-month period that begins with the month after your group health plan coverage or the employment it is based on ends, whichever comes first.

You can complete form CMS-40B (Application for Enrollment in Medicare – Part B [Medical Insurance]) at www.cms.gov/Medicare/CMS-Forms/CMS-Forms/CMS-Forms-Items/CMS017339 and CMS-L564 at www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/CMS-L564E.pdf (Request for Employment Information) online.

You can also fax the CMS-40B and CMS-L564 to 1-833-914-2016; or return forms by mail to your local Social Security office. Contact Social Security at 800-772-1213 (TTY 800-325-0778) if you have any questions.

Note: When completing the forms:

• 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, complete that portion as best you can on behalf of your employer without your employer’s signature.

Submit one of the following types of secondary evidence by uploading it from a saved document on your computer:

• 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.

Let your friends and loved ones know about this online, mail or fax option.

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