Medicare Enrollment Application – Who Has to Apply?

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  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

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

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.

177 Responses to Medicare Enrollment Application – Who Has to Apply?

  • Joseph says:

    I was born and live in California. I am 19 years old. Both my parents are institutionalized. I have medical issues and am unemployed and worked very little part time last year. Do I qualify for medicare or california medicaid

  • Tara says:

    I have been living abroad for the past 40 years. I am presently back in the USA temporarily, and turning 65 in September. Am I eligible for medicare from that date for the periods that I am in the USA (I am not a resident). I have a social number.
    What would I have to do before I reach 65?
    Also is my spouse eligible under my policy (he is not a US citizen)?
    With thank

  • Dell Gamble says:

    Im in the process of starting a ambulance company and would like to apply for my Medicare Ambulance Provider number. Can you tell me where to locate the application?

  • Jenny Chavez says:

    my dad is turning 59 in March and he’s unemployed (layed off) he has epilepsy and his medication is not covered… would he be eligable for medicare/medicaid????

  • Wanda says:

    I have a friend who is 49 years old, he is disabled and has just recently filled out the paper work for disability but has not recieved any disabilty benefits, while he is waiting he is unable to have his prescriptions filled, he is diabetic, has high blood pressure and other life threatening medical problems. He is unable to pay for these prescriptions, what can he do? Does he qualify for medicare in Tennessee?

  • Robert Robichaud says:

    I will turn 65 in July but I intend to continue working for at least several more years. As my wife and I both have full medical , dental and vision care coverage through my employer, will I still need to sign up for Medicare now? How will it effect my wife’s benefits as she is younger than I am?

  • sheryl palmieri says:

    I will be 63 in a few weeks. I have be laid off from my job and can’t afford cobra. I have arthiritis in my legs, lower back knees and feet. I had one hip replacement and need the other plus I have pins in one of my feet from an operation to fix a bone graft. What can I do for insurance.

  • alex apinis says:

    im married 59 and have a 15 year old daughter and 22 year old son living with me ive been on ssd for over 5 years and need medical insurance.also dental

  • Char Schlepp says:

    If an applicant is 65 and has applied for Medicare can his spouse who is 64 qualify for Medicare as well?

  • KSNAYAK says:

    I am greencard holder living with my daughter and a dependent without income here.My wife also lives with me and a depedent.Under the new medicare law,are we entitled to any benefits ?

  • Carrol says:

    I was 65 in January, 2010, and believe I was not automatically enrolled in Medicare Part A because it is now April 11, 2010, and I have not received a Medicare Card. What should I do to enroll in part A before my deadline of April 28, 2010?

  • Tanya Lee says:

    My grandfather is disabled and living in a nursing home that isnt doing what they are suppose to do. we are wanting to take him home and take care of him ourselves. does tn pay to take care of disabled family members ourselves. my mom is going to stay at home and is wondering if she could get paid for taking care of grandpa because she will have to be there all the time and not work.

  • Could you please send me an application for medicare to the following address: 757 North 32nd Street, Kansas City,Ks 66102 and please send it addressed to Loretta .A. Jackson-Cowans thanks for your time. Although this request isn’t an actual comment, I couldn’t find another way to ask for an application.

  • gary bell says:

    how long after 65 birthday does take to get medicare card.

  • Salbia says:

    I am green card holder and right now im unemployed and pregnant.
    my Question is that can i get medicare and will it effect on my immigration spouse case?
    What is prossessing to get medicare and where i have to apply for that to know about my eligbilty?

  • Leona Williams says:

    I will be 65 years old on 11/15 of this year.born IN 1945 I already have United Health Care, I’m also a diabetic with complications. When can I apply for medicare, what documents will I need and at which location in chICAGO SHOULD i GO TO, 8723 Siuth Calumet, chicago illiknois 60619.
    please respond

  • C. Williams says:

    My wife is covered under my medical plan which is provided through my company. We are both 74 years old and retired. We both have prior existing conditions. We are currently in an HMO (Senior Blue in Pennsylvania). The plan provided prescription coverage. Under my plan we don’t use our Medicare Cards … only our Senior Blue cards.

    If I die before she does, she loses my company coverage and will have to find her own coverage. We both have the monthly Medicare Part B taken out of our Social Security.

    Question 1: Will she be eligible for immediate coverage under Medicare?

    Question 2: Is she immediately eligible to purchase a gap coverage plan such as AARP Insurance or is there a waiting period, i.e., does she have to wait until the annual sign up period before she would be eligible?

  • william l leadbetter says:

    i signed up for medicare part b, told them i wanted it to start on july 1st. i have not recieved a card yet. am i enrolled in part b

  • Simeon says:

    I am 62 years old, no insurance and am diabetic. When do I quality for medicare / medicaid? please help. I dont have coverage and my meds are expensive. Thanks.

  • Robert says:

    I am applying my mother to immigrate to the United States. She is 75 years old, can I apply for Medicare or Medicaid once she is in the USA?

  • I am 61 years old. Have had 3 vascular surgeries,4 bypasses leg amputated and a defibulator what can I do to get medicare.

  • Hyebin Lee says:

    I’m a conditional green card holder (got my greencard in April 2010 after marriage). I lived in States for 10 years as an international student though. I’m currently pregnant and want to apply for medicaid. Am I eligable to? or will my sponsor be responsible if I apply for medicaid?
    Please email me for reply.

  • Nancy Mohrmann says:

    I ma a New York State registered physical therapist and need to get an application plus other information in order to be a medicare provider for my solo private practice , office-base.

  • Vicky says:

    my friend just turned 64 yesterday and he owns a business. He was diagnosed with throat cancer. Can he be eligible for Medicare a year early? what other types of programs could he be eligible for?thank you for any information you can give me..

  • Mano says:

    I am a naturalized US citizen. My parents are both 65+. They don’t live in this country and do not wish to settle here.

    If I bring them to US for 3-6 months, would they be eligible for medicare etc.? If not then is there any way for their medical coverage? They won’t come here without any insurance as that may be too risky.


  • Shan says:

    My grand mother is 70 years old and holds green card. She is ondering if she could get some medicare benefits from social security.

  • Renie says:

    Both my parents are green card holders and they are above 65 , are they eligible for a medicate or medicare?

  • Elizabeth says:

    I have medicare but can’t find my card. Can you email a form to fill out for a replacement?
    Thank you

  • Taylor Korkova says:

    hello, my uncle is 67 years old and has never worked in the US. He lived in Canada all his life and has recently gotten his green card about 4 years now, so he is not naturalised as yet. However, he has filing/paying taxes for the past 4 years. When can he apply for Medicare? He is paying USD$900 every mnth in health Insurance but can’t afford it anymore. He suffers from Scoliosis (major back problems) and had open heart surgery 5 yrs ago & had a heart attack recently. Therefore, he needs health insurance. Is heart problems considered a disability which qualifies him for Medicare. Please guide me through or render any suggestions.

  • Linda says:

    My dad is 90 years old & was recently put on oxygen by a Dr. at the V.A. Can he apply for & receive 100% disability?
    Thank you.

  • Vanessa says:

    My father is 48 years old and has a heart condition (open heart surgery, two heart attacks) and is unable to work but has only been living in the U.S (as a permanent resident) for 3 years with that being said when he initially applied for Social Security they denied it for that reason. What other way do you think we can go about applying? He currently has no health insurance or employment.

    Thank you in advance.

  • Topping the listing of changes this coming year is the sharp cut in the quantity of Medicare gain plans….Government studies have deducted the ‘advantage’ in you will find many Medicare appeal plans goes never to the plan holders, but to the bottom distinct the insurance underwriters selling typically the policies, and may well be a move because of the government towards phase these individuals out….the additional significant change this season is a great deal more prescription meds coverage for most people, but you cannot assume all, Medicare beneficiaries enrolled in the non-reflex drug approach

  • John Roznowski says:

    I will be 65 in june , I plan on continue working should I apply for Medicare . I have a very good plan at work were I pay in and so does the company I work for, what should I do.

  • Anna May Blang says:

    I am 64 and recieve Soc. Sec. through my husband. My question is, do I need to sign up for Medicare or will I start recieving it when turn 65 in Dec. of 2011? My husband is receiving full benefits.

  • Tanvir Shaikh says:

    My mom is 72 years old and she is a green card holder. She has never worked. How can i apply for medicare , medicaid for her.
    Please advice.

    Thank you,

  • roland buckner says:

    wife 64 i am 63 lost job . cobra ran out . both have pre-esisting issues . cant not afford to buy health insurance. accepted with missouri health plan. cost for wife and myself is $ 32000.00 year . so now i am paying for our own health care and meds. where do i go from here. just praying we dont get sick before we can apply for medicaid.

  • tom murphy says:

    I am still working and will soon be 65 and have applied for Medicare. Does my employer continue to take Medicare out of my pay check?

  • Denise says:

    I am 53 years old and I would like to know if I can apply for medicare. Thank you

  • orfe cardenas says:

    my daughter is 42 and was diagnosed with breast cancer requiiring mastectomy. She has a job and insurance but I
    heard around that if you are diagnosed with breast or uterine
    cancer, that you automatically qualify for medicare as a secondary
    insurance that will cover whatever her insurance doesn’t. How
    true is this?

  • Mary says:

    My father is disabled from stroke and is 63yo. He is not a citizen but is a legal resident of the US and has been living here for 30+ yrs. He is partially blind as well. He cannot work, would he qualify for medicare? And how do I proceed with applying.

  • Connie Birthright says:

    I am 67 years old and have Medicare Part A. I am still working and have been under my employer’s insurance. I will be loosing these medical benefits so will need Meducare Part B. How do I apply?

  • murad says:

    My mom is a green card holder and been in the US for almost 3 yrs she is a heart patient who is on 24 hr oxygen due to a heart condition….would she be able to get medicare or medicaid? Thanks

  • Marcia Garrison says:

    I dont have insurance at this time and am not working.

  • Gary says:

    i have been on social security disability for almost a year and i was wondering if my 3 children have to wait the 2 years like i do to get medical insured covered by SS of are they covered now?

  • Maria Nunez says:

    My aunt had cancer and was in remission for about a year. Her cancer has come back and this time more severe, where she may have her intestins and urethra removed, and life long treatments. My aunt is a nationalized us citizen and is in her mid 50’s. Would she qualify for medicare coverage? Please Help!

  • Lisa Hoilett says:

    I am a new business owner and would like to find out how to get started with medicare program. I business will required my staff to visit patients home..(Home Attandent) who is unable to take care of them selfs and family members is unable to do it also..I don’t know how to get started can you point me in the direction on were to start..
    Thank you

  • Laura Martin says:

    My daughter is 21 and lives with her boyfriends mother, she just recently found employment, she has severe anxiety attaches and cries constantly, she can not be on our insurance any longer and she can not afford her own, she is buying a car through us so she can get around as when she lost her job she had her car repossed. the car she is buying is in my name. is there anyway she can get on medicade? i believe the attacks are severe and if she can not get help with medical coverage i am not sure what will happen.

  • Kathy Zagel says:

    My husband and I are living and working in Australia and will be here at least through May 2012. I will be 65 in October 2011. How will that affect my Medicare eligibility and application?

  • john says:

    my wife has ms an needs my help i stopped working to take care of her can i get paid for this we live i lexington ky

  • Charlene Keitt says:

    I have passed the age of 65 and I am still working. I would like to enroll in Medicare as I believe it will save me from paying high rates for insurance coverage.

    Can you tell me where to begin.

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