Skip to Main Content
Form #
CMS 40B
Form Title
APPLICATION FOR ENROLLMENT IN MEDICARE
Revision Date
1990-01-01
O.M.B. #
EXEMPT
O.M.B. Expiration Date
N/A
CMS Manual
N/A
Special Instructions
You must either visit or contact the Social Security Administration office to obtain this form. 1-800-772-1213; TTY 1-800-325-0778