Medicare Resources — NISONA
Medicare Enrollment Forms
The right Medicare form at the right time can make the difference between seamless enrollment and a costly coverage gap. Here’s everything you need — explained in plain English.
Navigating Medicare enrollment requires specific forms depending on your situation — whether you’re enrolling for the first time, applying during a Special Enrollment Period, or qualifying for a unique circumstance. Below you’ll find every essential Medicare enrollment form, what it’s for, when to use it, and a direct download link. If you’re unsure which form applies to your situation, a local NISONA advisor can walk you through it at no charge. For a complete overview of your Medicare coverage options, visit our Medicare hub page.
Medicare Enrollment Forms
CMS-40B
Application for Enrollment in Medicare Part B
This is the primary form used to enroll in Medicare Part B (Medical Insurance). If you’re already enrolled in Part A and need to add Part B — whether during your Initial Enrollment Period or a Special Enrollment Period — this is the form you need.
Use this form when:
- You’re leaving employer or union coverage and need to enroll in Part B
- You delayed Part B enrollment and are now ready to sign up
- You’re applying for Part B during a Special Enrollment Period
- You’re enrolling in Part B for the first time after turning 65
⬇ Download CMS-40B
PDF — CMS Official Form
CMS-L564
Request for Employment Information
This form is required when applying for Medicare Part B during a Special Enrollment Period due to loss of group health plan coverage through active employment. It confirms you had qualifying employer or union coverage that allowed you to delay Medicare without penalty. It is almost always submitted together with the CMS-40B.
Important: Your employer completes Section B of this form. Make sure to give it to your HR department with enough lead time before your coverage ends.
Use this form when:
- You delayed Medicare Part B because you had active employer or union group health coverage
- You’re enrolling in Part B during a Special Enrollment Period after losing that coverage
- Social Security requests proof of prior employer coverage
⬇ Download CMS-L564
PDF — CMS Official Form
CMS-10797
Application for Medicare Part A & Part B — Special Enrollment Period (Exceptional Conditions)
This form is for individuals who qualify for a Special Enrollment Period under exceptional conditions — circumstances outside their control that prevented timely enrollment. This is a less common form, used only in specific qualifying situations.
Qualifying exceptional conditions include:
- You were affected by a FEMA-declared natural disaster during your enrollment period
- You received incorrect information from a federal employee (Social Security, CMS, etc.) that caused you to miss your enrollment window
- Other circumstances beyond your control prevented timely enrollment
⬇ Download CMS-10797
PDF — CMS Official Form
CMS-10798
Application for Enrollment in Part B Immunosuppressive Drug Coverage
This is a specialized form for a specific situation: individuals who have had a kidney transplant, lost full Medicare coverage, but still need Part B coverage specifically for immunosuppressive drug therapy. This benefit was introduced in 2023 and applies to a narrow group of Medicare beneficiaries.
Use this form when:
- You’ve had a kidney transplant and lost full Medicare coverage
- You still require ongoing immunosuppressive drug therapy
- You need Part B coverage specifically for those medications
⬇ Download CMS-10798
PDF — CMS Official Form
How to Submit Medicare Forms
Once you’ve completed your form, you have three options for submitting it to Social Security or CMS:
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💻 Online
Submit through your MyMedicare.gov account or the Social Security Administration website at ssa.gov. Fastest processing for straightforward enrollments.
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✉ By Mail
Mail completed forms to your local Social Security office. Always keep a copy of everything you submit. Allow 2–4 weeks for processing.
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🏠 In Person
Visit your nearest Social Security office. An appointment is recommended — call 1-800-772-1213 to schedule. Bring photo ID and any supporting documents.
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Additional Medicare Resources
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📄 NISONA New to Medicare Guide
Our free guide covers your Medicare coverage options, 2026 costs, and enrollment timelines in plain English — written specifically for Florida seniors.
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📄 2026 Medicare & You Handbook
The official CMS Medicare handbook — your complete guide to benefits, rights, costs, and coverage options for 2026. Published annually by the Centers for Medicare & Medicaid Services.
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📄 Medicare & Employer Coverage at 65
Still working at 65? This guide from CMS explains how Medicare coordinates with employer coverage and how to avoid costly enrollment mistakes when transitioning from employer insurance.
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🌐 Official Medicare Resources
Medicare.gov: medicare.gov
Social Security: ssa.gov Medicare helpline: 1-800-MEDICARE (1-800-633-4227) Social Security: 1-800-772-1213 |
Learn More About Medicare
Not Sure Which Form You Need?
A local NISONA advisor can review your situation, tell you exactly which forms apply, and help you avoid common enrollment mistakes — at no cost to you.
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