Medicare Forms

Applications

Application for Enrollment in Medicare Part B

The CMS-40B form is for enrolling in Part B. You must apply for Part A first.

Request for Employment Information

The CMS-L564 form is used when applying for employer group health plan coverage.

Medicare Easy Pay

This form is used to sign up for Medicare's Easy Pay electronic, automatic payment option.

Request for Termination of Medicare Part B

The CMS-1763 508 form is for terminating enrollment in Part B. 

SSA-44 Life-Changing Event Form

If you have had a major life-changing event and your income has gone down, use this form to request a change to your monthly adjustment amount.

Handbooks

Medicare & You

This handbook covers plans and benefits, beneficiaries' rights, and frequently asked questions.
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