# Form CMS-40B

URL: https://pdf.net/pdf-forms/healthcare-forms/cms-40b-form
Category: Healthcare Forms
Attributes: 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!”

## Versions

- 2025 — [download PDF](https://cdn.sanity.io/files/i16te7yp/production/8382022a3735192ce8c3ddd717987064cb2707ef.pdf)

## 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.

## Facts

### 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.

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