Menard Wurtz Agency

Scope of Appointment The Medicare Scope of Appointment helps ensure you get the information you need to make an informed decision about which Medicare Advantage plan and/or Medicare Part D plan is right for you. It limits your discussion to the scope of healthcare products you agree to in advance.

Create a My Social Security account Signing up for Medicare online through the Social Security Administration is the fastest way to apply.

Apply for Benefits Visit the Social Security Administration’s page. Click “Start a New Application.”

Create a My Medicare Account After you sign up for Medicare, you can create a MyMedicare.gov account to manage your coverage.

Application on the Social Security website If you enroll in Part B after your group health insurance ends, you have options for how to apply. You can do so online through an  or by mail.

CMS 40B Form Print out and complete CMS 40B Form. Application for Enrollment in Medicare – Part B (Medical Insurance).

CMS L564 Form Print out and complete Section A of CMS L564 Form – Request for Employment Information.

Social Security Administration Your Medicare benefits are administered by the U.S. Centers for Medicare & Medicaid Services, or CMS.Source: 

Social Security office locator Visit your local Social Security office. You can use the locator to find your nearest location.

20 qualifying special circumstances Certain life events may also allow you to make changes to your Medicare coverage if you qualify for a special enrollment period.

Authorization to Disclose Personal Health Information I want to make sure Medicare can give my personal health information to someone other than me (Authorization to Disclose Personal Health Information form/CMS-10106). This form is available both in English and Spanish.