HOW TO ENROLL IN MEDICARE PART B IF YOU ARE ENROLLED IN MEDICARE PART A
There are two forms you need
One form should be completed by you and other form should be completed by your employer (or your spouse’s employer – whichever is applicable). You will either fax or mail both completed forms to Social Security.
You can choose to complete the forms online. This is especially important if you are under a tight deadline or want to ensure receipt of your request. Here is a video demo if you’re completing the online application and need additional help.
Click the links below to download BOTH forms if you will be faxing or mailing. Note* we recommend if mailing these forms that you make copies to keep for your records and send the forms with tracking. Here is the information you need to fax or mail to your local Social Security office.