2025 Printable Template
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Form last updated: 03/2024. Please verify this is the current version before use.
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What is a CMS 40B used for?
Form CMS-40B is used by individuals who are eligible for Medicare and wish to enroll in Medicare Part B, which provides medical insurance coverage. This form is important for those who did not sign up for Part B when they were first eligible and are now seeking to enroll during a Special Enrollment Period or General Enrollment Period.
Who needs to fill out a CMS 40B form
Individuals eligible for Medicare who are applying for Medicare Part B coverage.
How to fill out a CMS 40B online?
Follow these steps to complete your CMS 40B form online.
Frequently Asked Questions
Find quick answers to common questions about our PDF editor.
Form CMS-40B is the application used to enroll in Medicare Part B, which covers medical services.
You can submit the form during your Initial Enrollment Period, Special Enrollment Period, or General Enrollment Period.
You can access a blank version of Form CMS-40B from the Centers for Medicare & Medicaid Services or the Social Security Administration.
