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Cms 40b Form: What You Should Know
Coverage) online. You do not need a Social Security Number to apply online; you only need a social security number (SSN). This form allows you to apply for Part B by mail. Why mail it? If the agency asks for Social Security Identification Numbers (SSN) you do not need to provide them. If you need them later you can return to the Social Security office that signed you up. You will need to fill out Part B — Medicare Application for Coverage and will have to provide proof of coverage using your SSN. Where can I access this form? Your county medical office and Department of Health and Human Services (HHS). Note: If you have not previously completed the application for Medicare Part A, you must complete this form before you are eligible for coverage. CMS40B Form (01/00) Do I need to complete this form? You need to complete this form if you are applying for Part B (Medical. Insurance) and have previously completed a Part A — Application for Coverage for Children, Infants and Children, or Part B — Application for Coverage for Families, or both. How much does it cost? The fee is 13.00, or you can pay by check, money order, or money order with electronic funds transfer from a U.S. bank or building and loan (EFT), with your Social Security Number showing on the EFT bill, with your bank or institution's authorization. What should I include on my Form? I will use this form to demonstrate that, because I am an individual, I will not provide information to the IRS on the form. In other words, do not include your Social Security Number (SSN) in the following text in black ink or red ink: If I file a joint return with: my spouse (other than my spouse's son or daughter, in the case of a child younger than 21) (or) my spouse's son or daughter, in the case of a child younger than 21 If I do not file a joint return with my spouse, do include him or hers name or child's name at the top of the form. You may enter your name on either line 1 or line 2 if your Social Security Number is shown and your name is the same.
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