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NEED YOUR MEDICARE FORMS?
Look no further. We've got you covered here too.
MEDICARE FORMS
Below are important forms you may need now to start your Medicare, give to your employer or make a payment. These are the forms on Medicare.gov but we make it easy for you all in one place.
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Use this form if you are over the age of 65, have been covered by a group health plan, and now want to start Medicare Part B.
Application to start Medicare part B cms-40b​
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Use this form if you are over the age of 65, have been covered by a group health plan, and now want inform Social Security / Medicare that you are losing group coverage and now qualify for a Life Event / Special Enrollment Period.
employer must fill out cms-l564e​
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Use this form if you are not currently receiving you Social Security Income Benefit Check and would like Medicare to draft your checking account for the Medicare Part B Premium monthly payment.
Medicare easy pay form​
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Income Related Monthly Adjusted Amount (IRMAA). Use this form if you are making less in the coming year than Medicare believes you will be making and Medicare is increasing your Part B and Part D premium payments.
irmaa life event form​
Form to cancel or drop Part a/part b​
