Official form collection
Medicare forms and guides
Browse Medicare enrollment, coverage, prescription-drug assistance, and income-related premium forms listed by SSA.
5 forms in this collection
CMS-40B PDF
Application for Enrollment in Medicare - Part B (Medical Insurance)
CMS-40B, Application for Enrollment in Medicare - Part B (Medical Insurance), is an official Centers for Medicare & Medicaid Services PDF listed in the Social Security Administration forms directory. This guide explains what to prepare, how to review the form, and where to get the current government download.
Read guideCMS-1763 PDF
Request for Termination of Premium Part A, Part B, or Part B Immunosuppressive Drug Coverage
CMS-1763, Request for Termination of Premium Part A, Part B, or Part B Immunosuppressive Drug Coverage, is an official Centers for Medicare & Medicaid Services PDF listed in the Social Security Administration forms directory. This guide explains what to prepare, how to review the form, and where to get the current government download.
Read guideCMS-L564 PDF
Request for Employment Information
CMS-L564, Request for Employment Information, is an official Centers for Medicare & Medicaid Services PDF listed in the Social Security Administration forms directory. This guide explains what to prepare, how to review the form, and where to get the current government download.
Read guideSSA-44 PDF
Medicare Income-Related Monthly Adjustment Amount - Life-Changing Event
SSA-44, Medicare Income-Related Monthly Adjustment Amount - Life-Changing Event, is an official Social Security Administration PDF listed in the Social Security Administration forms directory. This guide explains what to prepare, how to review the form, and where to get the current government download.
Read guideSSA-1021 PDF
Appeal of Determination for Extra Help with Medicare Prescription Drug Plan Costs
SSA-1021, Appeal of Determination for Extra Help with Medicare Prescription Drug Plan Costs, is an official Social Security Administration PDF listed in the Social Security Administration forms directory. This guide explains what to prepare, how to review the form, and where to get the current government download.
Read guide