Medicare enrollment form

How to Enroll in Medicare During the Corona Virus Emergency

Here are the latest Medicare Enrollment postings to the Social Security & Coronavirus Disease (COVID-19) website:

Can I enroll in Medicare?

Date: April 14, 2020

If you already have Medicare Part A and wish to sign up for Medicare Part B under the Special Enrollment Period (SEP), please complete form CMS 40-B, Application for Enrollment in Medicare – Part B (Medical Insurance) along with the CMS L564-Request for Employment Information and proof of employment, Group Health Plan (GHP), or Large Group Health Plan (LGHP). Return the completed forms to your Social Security office by mail or by fax to 1-833-914-2016.

Note When completing the CMS L564

  • State on the form “I want Part B coverage to begin (MM/YY)”
  • If possible, your employer should complete Section B.
  • If your employer is unable to complete Section B, please complete that portion on behalf of your employer without your employers signature and submit one of the following forms of secondary evidence:
    • income tax form that shows health insurance premiums paid;
    • W-2s reflecting pre-tax medical contributions;
    • pay stubs that reflect health insurance premium deductions;
    • health insurance cards with a policy effective date;
    • explanations of benefits paid by the GHP or LGHP; or
    • statements or receipts that reflect payment of health insurance premiums.

Can SSA help me by phone?

Date: April 14, 2020

During the COVID-19 pandemic, we are asking the public to first try to use our online services before calling us.

If you cannot use these online services, although our offices are closed to the public, employees from those offices are assisting people by telephone. You can find the phone number for your local office by using our Field Office Locator and looking under Additional Office Information. (Note, if you already had a scheduled appointment with your local office, an employee from that office will attempt to call you at your scheduled appointment time.)

If you cannot use our online services or reach your local office, you may call our National 800 Number, where you may be able to take care of your business by using one of our automated telephone services without having to wait for a telephone agent. If you need to speak with an agent, be aware that wait times are longer than usual. You may have to wait 90 minutes or longer, which is why we encourage you to try our online services or call your local office first.

Main Nationwide Phone Number — 1-800-772-1213

To Find Your Local Office Phone Number Go To Local Field Office Locator , enter your zip code and then look for the phone number at the bottom of the page.

For more information you can go here – https://www.ssa.gov/coronavirus/



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