Medicare Enrollment Application - Who Has to Apply? 
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Medicare is a health insurance program provided by the United States government. The Medicare Program covers citizens who are 65 years old or older, or those meeting other specific criteria.
The Medicare program is administered by the Centers for Medicare and Medicaid Services (CMS) department. In order for you to take advantage of Medicare, and for your physician to accept your coverage, you must both complete a Medicare application.
Medicare coverage and information is subject to change without notice. You should always check with your local Social Security agency before relying solely on this article.
Individual Coverage
Most people qualify for Medicare when they reach 65 years old or if certain medical conditions apply. Anyone already receiving Social Security benefits will automatically enrolled in Medicare Parts A and B. Because you must pay a premium for Part B coverage, you have the choice not to include Part B coverage on your Medicare application. Persons who are automatically eligible will be notified several months prior to their eligibility birthdate with the proper information.
Individuals who are not automatically enrolled must complete the Medicare application CMS 40B, Application for Enrollment in Medicare. To obtain this form, you must either visit your local Social Security Administration office or arrange for a Medicare application appointment at 1-800-772-1213.
For convenience, an application for monthly benefits for retirement, disability, or a spouse is often submitted with the Medicare application. It is possible to apply for these monthly benefits online at www.socialsecurity.gov/applyforbenefits Your local Social Security office can also help you with this application.
Provider Coverage
Medical providers desiring to participate in the Medicare health insurance program must submit a Medicare application. One example applicable to doctors, hospitals, and ambulance is Form CMS 10115, Section 1011 Provider Enrollment Application. This relatively short form requires basic contact information as well as the applicant’s Medicare Identification Number, Federal Tax Identification Number, and, for hospitals only, lists of physicians with hospital privileges and their provider numbers.
Examples of a Medicare application for different providers include:
Form CMS 855A, Medical Enrollment Application - Institutional Providers
applies to: Community Mental Health Centers, Comprehensive Outpatient
Rehabilitation Facilities, Critical Access Hospitals, End-Stage Renal Disease Facilities, Federally Qualified Health Centers, and other facilities specifically listed on the application. This Medicare application is available for download from http://www.cms.hhs.gov/cmsforms/downloads/cms855a.pdf
Form CMS 855B is entitled Medicare Enrollment Application - Clinics/Group Practices and Certain Other Suppliers. It applies to Ambulance Service Suppliers, Ambulatory Surgical Centers, Clinic/Group Practices, Independent Clinical Laboratories, and other facilities specifically listed on the application. It is available for download from http://www.cms.hhs.gov/CMSforms/downloads/cms855b.pdf
The Beginning of the Medicare Paper Trail
There are many more Medicare application forms available than can be discussed or even listed here. Whether you are a doctor or a patient, the enrollment process begins with the Medicare application.
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30 Comments Add your own
1. Robin Crowder | April 11th, 2007 at 11:59 pm
My sister came down from Oregon for a vacation and had a stroke while on the airplane. She is unalbe to work and I would like to find out if she is eligable for Medicare or if I should be signing her up for something else. She will not be returning home to Oregon, she will be living in a studio home on my property. Thanks for your time.
2. admin | April 12th, 2007 at 1:43 am
Hi Robin,
How old is your sister? If she is not yet of the required age for Medicare, she may be able to qualify early, depending on a number of factors. Your best bet is to get her in touch with a elder care advisor.
3. LINDA TUCKER | June 27th, 2007 at 6:35 pm
I WANT TO FIND OUT IF MY SON, AGE 27, WHO IS DISABLED WITH CEREBRAL PALSY AND LIVES AT HOME IS ELIGIBLE FOR ANY OTHER MEDICAL SERVICES.
HE NOW HAS PASSPORT AND A KY HEALTH CARD (MEDICAID?)
IT IS VERY HARD TO FIND A DOCTOR WHO ACCEPTS THESE BENEFITS, ESPECIALLY IF YOU NEED A SPECIALIST.
IS THERE ANY OTHER PLANS? WHAT ABOUT MEDICARE?
THANK YOU
4. admin | July 12th, 2007 at 1:32 pm
Hi Linda,
You should seek out a social worker in your area to assist you in finding additional coverage for your son. As far as Medicare goes, there’s a chance he could quality. Your best bet is to call 1-800-MEDICARE and ask an agent about your situation.
Good luck.
5. Bhaskar | July 13th, 2007 at 7:47 pm
My father is 65+ and mother is 58. Both are green card holder. Are they eligible for medicare or medicaid? They have not worked in USA.
6. admin | July 13th, 2007 at 8:39 pm
Bhaskar,
Your father and mother who are green card holders may be eligible for Medicare part B. You can read this for more information:
Medicare FAQ on Eligibilty
For a more sure answer, I recommend you call Medicare or your state’s Medicaid office. Medicare’s toll-free number is 1-800-MEDICARE.
7. Mike | August 8th, 2007 at 4:18 pm
My friend came legally to US 2 years ago. He is 65+ and he is a permanent resident green card holder. His wife is not 65 yet.
Does he qualify for Medicare?
What is the application process?
Thank you
Mike
8. Billy L. Bray | August 15th, 2007 at 6:26 pm
I am automatically enrolled in Medicare. I am also covered by my wife’s plan (United Healthcare) for dental and drugs. I don;t understand what coverage is available from whom to cover the new deductables, copayments, coinsurance,etc and don’t want to suffer any period of noncoverage or imcomplete coverage. United can’t tell me until I am automaticall enrolled in Medicare. Do you have any suggestions.
9. Billy L. Bray | August 15th, 2007 at 6:30 pm
I never received my Medicare card. When I requested a card (new card) I was told it would take 4-8 weeks. Isn’t that a little rediculous to require over a month to get something that was never sent in the first place. How long does it take to print out and send out a little card.
10. Noelle | August 20th, 2007 at 5:47 pm
My brother is waiting for a Work. Comp settlement & is currently disabled. He’s just waiting to find out if he’s partial, or full from the medical report.
Can he apply for medicare if he’s under 65? Will medicare check the final medical report & find him eligible if there is a permanent disability?
11. lisa garcia | September 24th, 2007 at 11:59 pm
My sister who currently 60yrs old has 2 bad knees and know knee cap in her left knee. She is unable to walk on her own. Can she qualify for medicare prior to 65yrs old?
12. Matthew P. Fisher | October 26th, 2007 at 11:29 pm
Will reach 65 years of age on Oct 20, 2008. Was diagnosed with Severe Degenerative Disk Disease and related problems over 10 years ago. Recently diagnosed with Prostate Cancer. Both conditions have severely limited work in my accounting practice and am now retired. Would I be able to enter the Medicare program early?
Thank You,
Matt
13. Jay Jayachandran | November 15th, 2007 at 12:15 pm
My mother-in-law is 72 years old. She has never worked (outside her home) in her life. She is a naturalized citizen. She has never applied for SSI or Medicare. Now that she is getting old, how do we apply for Medicare and SSI for her?
Please HELP.
Thanks.
Jay.
14. michael harp | November 18th, 2007 at 7:56 am
I used to have it and medicade, at no cost to me, I’m disable. how can I get it back with out them taking it out of my check. I only make 690.00 a month, can you help me get it with out them taking out of my check. thanks for your time, mike harp…
15. Amber | November 28th, 2007 at 9:09 am
My boyfriend is currently without any insurance at all and he needs insurance. His job doesnt have insurance and he needs some. He told me to check with Medicaid and ask if he is eligible for it. He is 24 and he doesnt have any insurance for his self at all. He needs some because he also gets hurt out of work and he is sick. He doesnt have insurance so he wont go to the doctor. Can you help me please.
16. rae | November 29th, 2007 at 2:17 pm
hi im a full time student and due to change in my schedule and work life I will be losing my benefits by january 1st, 2008. If I remain a full time student, which I intend to, am I eligible for medicare?
17. Charles H Beauchamp | December 7th, 2007 at 9:31 pm
I am a retired soldier and social security recepient who turned 65
August 2007. What do I need to do to get my Medicare Card or how do I go about applying. I also have Tricare for Life
18. Kathleen Crestwell | December 24th, 2007 at 7:04 pm
I will be turning 65 on April 21, 2008. What is the latest date that I can enroll in Medicare?
19. My name is Maxine | January 8th, 2008 at 11:26 pm
My husband had a stroke, he is disable his condition is getting worse, they said he cannot get medicare until he is 62.
20. Donn Coon | January 15th, 2008 at 11:42 am
I applied for Soc Sec benefits in Nov 2007. My first month of eligibility is Jan 2008. I tun 65 in July 2008. Do I need to apply separately for Medicare, or is it automatic when I applied for Soc Sec?
21. gary kirsch | January 19th, 2008 at 2:59 pm
I am 64 years old. My birth date is 4/19/43. I have been told that I need to enroll for medicare 3 months prior to to turning 65. I will not be retiring any time soon. I work for the union which provides all health insurance needs. What is required of me at this time? Do I have to pay some sort of monthly payment? Do companies you work for automatically enroll you?
22. annette body | January 23rd, 2008 at 2:40 pm
i would like information about /apply for a medicare card i have high blood pressure and i am also borden line diabetse if you could help me/apporment some who could i would be very greatful .thank you
23. Betty | January 26th, 2008 at 6:50 pm
My husband had to go on disibilty last year sept. o7′ his ins.will
cary him for one year sept.08; He is 63 now. He needs lots of meds. Can he get medicade to help him untill he is 65?
24. John Riley | February 1st, 2008 at 3:13 pm
I will be 65 in a little over 3 months. I have been told that I need to register for Medicare in the 3 months prior to turning 65. However, I plan to keep working and receiving employer medical insurance for several more years. Do I need to sign up as I have been told? If not, when must I do that?
25. Mary Gregory | March 4th, 2008 at 7:42 pm
My husband will be 65 this July, where does he obtain an application for parts A & B?
26. Richard W. Eckman | July 16th, 2008 at 3:05 pm
I will be 65 on January 21, 2009. Where do I obtain an application for parts A and B
27. mike lucas | August 4th, 2008 at 4:15 pm
For some reason I cannot download the information. I will be 65 this month and understand that I need to apply for Medicare.
Thank You!
28. Linda Fagan | September 22nd, 2008 at 11:54 am
My mom is disable and will be 61 in march. when can she get on medicare. she needs to be going to the dr.
29. robert laflamme | October 6th, 2008 at 2:32 pm
MY SON IS A NATURALIZED U.S. CITIZEN . HE WAS BORN IN THE U.S. BOTH PARENTS ARE U.S. CITIZENS . WE MOVED TO CANADA WHEN SON WAS 5 YEARS OLD . PARENT MOVED BACK TO U.S . SON STAYED IN CANADA AND WORKED IN CANADA FOR 20 YEARS AND CURENTLY WORKING IN CANADA . SON PLANS TO RETIRE IN THE U.S. .IS HE ELIGIBLE TO ENROLL IN MEDICARE . IF YES WHAT STEPS MUST HE TAKE . ALSO HE MARRIED A CANADIAN WOMAN WOULD SHE ALSO BE ELIGIBLE IF MY SON IS ELIGIBLE
30. Norman Thomas | October 19th, 2008 at 12:25 pm
I am 75 years of age .I have a green card since June 1 2007. But I have been working and paying medicare since June 1 2004. When will I be eligible to apply for medicare .
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