Turning 65 and You want Part A ONLY
You need to sign up for Medicare A using this form: Application for Part A (Hospital Insurance) (cms.gov)
The Part B signup is almost hidden on this form so on "5B" make sure you check off NO.
Bring this form to your Social Security Office or fax them to your local social security office. You can find your local office at this link: Social Security Office Locator, SSA Office Locator Social Security Office Locator, Social Security
Turning 65 and You Need Part A & Part B
You need to sign up for Medicare A & B using this form: Application for Part A (Hospital Insurance) (cms.gov)
The Part B signup is almost hidden on this form so on "5B" make sure you check off YES.
Bring this form to your Social Security Office or fax them to your local social security office. You can find your local office at this link: Social Security Office Locator, SSA Office Locator Social Security Office Locator, Social Security
Over 65 and Already have Part A & Just Need Part B and must provide Proof of Creditable Insurance since turning 65
You will need to sign up for Part B-Only. You can fill out these forms and fax them to your local social security office (or drop them off). You can also make an appointment at your local social security office to review the completed forms with them before submitting.
- Application for Enrollment in Medicare Part B (CMS-40B) (PDF).
- Request for Employment Information (CMS-L564) (PDF) - You need to show all creditable health insurance since you turned 65 and get your employer to sign this form before submitting.
You can find your local office at this link: Social Security Office Locator, SSA Office Locator Social Security Office Locator, Social Security
Over 65 and Need Part A & Part B and Need Proof of Creditable Insurance since turning 65
You need to sign up for Medicare A & B using this form: Application for Part A (Hospital Insurance) (cms.gov)
The Part B signup is almost hidden on this form so on "5B" make sure you check off YES.
Since you are older than 65 you need to show all creditable health insurance since you turned 65. You need to fill out this form: Request for Employment Information (CMS-L564) (PDF) and get your employer to sign it.
Bring these 2 forms filled out completely to your Social Security Office or fax them to your local social security office. You can find your local office at this link: Social Security Office Locator, SSA Office Locator Social Security Office Locator, Social Security