Sign up for Medicare Part B Online

You can sign up for Medicare Part B online! If you’re enrolled in Medicare Part A and  want to enroll in Part B during the Special Enrollment Period, please visit our Medicare  web page at 

medicareFrom there, you can enroll in Part B by completing these forms: CMS-40B (Application  for Enrollment in Medicare – Part B [Medical Insurance]) and CMS-L564 (Request for  Employment Information)

You can also fax or mail the CMS-40B and CMS-L564 to your local Social Security  office to enroll. You can find the fax number and address for your local office at Please contact Social Security at 1-800-772-1213 (TTY 1-800- 325-0778) if you have any questions. 

Note: When completing the forms: 

  • State, “I want Part B coverage to begin (MM/YY)” in the remarks section of the  CMS-40B form or online application. 
  • If your employer is unable to complete Section B, please complete that portion as  best you can on behalf of your employer without your employer’s signature. • Submit one of the following types of secondary evidence by uploading it from a  saved document on your computer:  
  • Income tax returns that show health insurance premiums paid. 
  • W-2s reflecting pre-tax medical contributions. 
  • Pay stubs that reflect health insurance premium deductions. 
  • Health insurance cards with a policy effective date. 
  • Explanations of benefits paid by the Group Health Plan or Large Group  Health Plan. 
  • Statements or receipts that reflect payment of health insurance  premiums. 

Please let your friends and loved ones know about this online, mail, or fax option.