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Form CMS-40B
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Form CMS-40B

2025
Trusted by accountants
Trusted by accountants

Form CMS-40B helps you sign up for medical insurance for outpatient services, called Medicare Part B, if you’re already enrolled in Medicare Part A.

Our fillable Form CMS-40B can be completed in just a few clicks; open it in our PDF editor and type directly into the document. Then, you can easily download and print it to submit it to your local Social Security office.

“I used pdf.net to complete my CMS-40B, and I’m really happy with my experience. Everything went smoothly, and the service saved me hours!”

Form CMS-40B

2025
Form CMS-40B
Fill Form
Trusted by accountants
Trusted by accountants

Form CMS-40B helps you sign up for medical insurance for outpatient services, called Medicare Part B, if you’re already enrolled in Medicare Part A.

Our fillable Form CMS-40B can be completed in just a few clicks; open it in our PDF editor and type directly into the document. Then, you can easily download and print it to submit it to your local Social Security office.

“I used pdf.net to complete my CMS-40B, and I’m really happy with my experience. Everything went smoothly, and the service saved me hours!”

How to Fill Out a CMS-40B Form

Step 1: Check your eligibility for different enrollment periods.

Step 2: Open Form CMS-40B in our PDF editor.

Step 3: Fill out Section 1 with your basic information (Medicare number, name, address, etc.).

Step 4: Complete Section B according to the Form CMS-40B instructions to enroll in Part B.

Step 5: Sign the form and have a witness sign it if necessary.

Step 6: Submit it to your local Social Security office.

What Is CMS-40B Form Used For?

Form CMS-40B is used to sign up for Medicare Part B, which entails outpatient services like doctor visits, treatment in clinics, and preventive care. The individual who applies must already be enrolled in Medicare Part A, which covers inpatient hospital stays.

Who Should Use CMS-40B Form?

Form CMS-40B should be used by all individuals who are enrolled in Medicare Part A and wish to add Part B to their insurance plan.

When Is the CMS-40B Form Due?

There are three different deadlines for Form CMS-40B depending on the enrollment period:

  • Initial Enrollment Period, which starts three months before the month when you turn 65 and ends three months after
  • General Enrollment Period, which lasts from January 1st to March 31st each year
  • Special Enrollment Period, which applies to those who were covered by an active employer group health plan, but the coverage ended in the last eight months

Are There Penalties for Not Filing the CMS-40B Form?

There are penalties for not filing Form CMS-40B: an extra 10% payment for each year you could’ve signed up for Medicare Part B, but didn’t. This doesn’t apply if you’re eligible for the Special Enrollment Period.

How and Where Do I File the CMS-40B Form?

You should file Form CMS-40B with your local Social Security office, either by mail or in person. E-filing is also available on the official Social Security Administration website; look for the “Sign up for Part B only” page to find the application. You’ll need a registered account for this, though.

How to Get Your CMS-40B Form

  1. Open the printable Form CMS-40B
    Open the printable Form CMS-40B
    1

    Open the printable Form CMS-40B

  2. Fill out the document as instructed
    Fill out the document as instructed
    2

    Fill out the document as instructed

  3. Download Form CMS-40B to your device
    Download Form CMS-40B to your device
    3

    Download Form CMS-40B to your device

#1. How do I get a blank CMS-40B Form?

You can get a blank Form CMS-40B from pdf.net or several other official sources, such as the Centers for Medicare & Medicaid Services and Social Security Administration. Once you obtain the document, open it in our editor to quickly fill it out.

#2. Can I submit a CMS-40B Form electronically?

You can submit Form CMS-40B electronically if you use the official Social Security Administration website and navigate to the “Sign up for Medicare” page. There, you’ll find the “Sign up for Part B only,” which will take you to the application form.

#3. What if my CMS-40B Form is missing information?

If your Form CMS-40B is missing information, your application for Medicare Part B may be delayed or rejected. This may incur penalties if you miss your enrollment deadline, so it’s important to refer to a Form CMS-40B example to ensure everything’s in place.

If you wish to update an already submitted form, contact your local Social Security office for assistance. In most cases, you’ll be asked to send a correctly filled-out form to replace the original one.

#4. Can I fill out my CMS-40B Form online?

You can fill out your Form CMS-40B online if you use our PDF editor or the SSA platform for online filing.

#5. Is this form free?

This form is free to view and edit, but you need to purchase one of the available subscription plans if you want to download it. Take a look at the options on our pricing page.

#6. Can I correct mistakes on the CMS-40B Form?

You can correct mistakes on Form CMS-40B, but you must contact the SSA to inform yourself about the necessary steps. You’ll most likely be asked to submit a new form.

#7. Do I need to submit CMS-40B with any other forms?

You need to submit Form CMS-40B with Form CMS-L564 (Request for Employment Information) only if you’re applying for the Special Enrollment Period. This is because the SSA requires proof of eligibility to allow you to enroll at this time. You don’t need any additional forms if you’re applying during other periods.