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This form is your application for Medicare Part B (Medical Insurance). You can use this form to sign up for Part B: • During your Initial Enrollment Period (IEP) when you’re first eligible for Medicare • During the General Enrollment Period (GEP) from January 1 through March 31 of each year
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You retired within the last 8 months. You lost job-based health coverage within the last 8 months. To sign up for Part B in one of these situations, you’ll also need to fill out and submit an Application for Enrollment in Part B (CMS-40B) form at the same time.
The CMS-855R (Reassignment of Medicare Benefits) form has been discontinued. For additional information regarding the Medicare enrollment process (including Internet-based PECOS) and to get the current version of the CMS-855I, go to CMS.gov/Medicare/Provider-Enrollment-and-Certification.
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When to sign up for Medicare. Most people sign up for Part A (hospital insurance) and Part B (medical insurance) when they're first eligible, typically at age 65. It's important to sign up promptly to avoid gaps in coverage or late enrollment penalties.
You can enroll in a Medicare Advantage plan during your Initial Enrollment Period (IEP), as explained under the “Signing up for Medicare” section, once you become eligible for Medicare. You can also enroll during the annual Medicare open enrollment period from October 15 to December 7 each year. The effective date
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Sign up for Medicare. If you're 65 or older, you can enroll online for Parts A and B, or Part A only. You can delay Part B if you're already covered through an employer group health plan. The application is for retirement benefits and Medicare, or Medicare only. Apply online.
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How do I sign up for Medicare?
The General Enrollment Period for Original Medicare is January 1 through March 31 each year. Apply during this time if you missed the IEP (when you were first eligible), but keep in mind you may have to pay a late enrollment penalty.