The Centers for Medicare & Medicaid Services (CMS) would like to notify you of updates made to two Medicare enrollment forms: Form CMS-40B (Application for Enrollment in Medicare Part B (Medical Insurance)) and Form CMS-L564 (Request for Employment Information), which is required when a beneficiary is seeking a special enrollment period to enroll in Medicare Part B or premium Part A.
The CMS updated the forms to be more user-friendly by including information about when to use the forms and providing step-by-step instructions to assist Medicare beneficiaries in completing them. Beneficiaries can now obtain the enrollment forms online in English and Spanish, alleviating the need to contact the Social Security Administration (SSA) to obtain the forms by mail or in person.
This change especially helpful for beneficiaries living in Puerto Rico, who previously did not have access to the enrollment forms in Spanish. Additionally, for those beneficiaries who SSA automatically enrolls in Medicare Part A, they may now obtain and complete the Part B enrollment form prior to or in place of visiting their local SSA field office.
CMS worked with SSA to update these forms to be accessible and user-friendly to all Medicare beneficiaries.
