SF-5510
Medicare Easy Pay
Use this form to request automatic monthly withdrawal for Medicare premium payments.
View form guideForms
Useful Medicare and Social Security forms
Forms are only helpful when you know why you are using them. Start here to understand common CMS and SSA forms before you download or submit anything.
CMS-L564
Proof of Employment Coverage
This form is commonly used to document employer coverage when someone signs up for Part B after working past 65.
View form guideSSA-44
IRMAA Life-Changing Event
Use this Social Security form to request a lower IRMAA after certain income-reducing life-changing events.
View form guideCMS-40B
Part B Enrollment Application
This form is used to request enrollment in Medicare Part B medical insurance.
View form guideCMS-1763
Terminate Medicare Part A or Part B
This form starts the request to terminate Medicare Part A and/or Part B coverage.
View form guideCMS-10287
Quality of Care Complaint
Use this form to file a Medicare quality-of-care complaint.
View form guideCMS-1490S
Patient Request for Medical Payment
Use this form when a Medicare claim needs to be filed by the patient instead of being filed automatically by a provider.
View form guideSSA-634
Change Social Security Overpayment Recovery Rate
Use this Social Security form to request a different overpayment recovery rate when the current withholding creates hardship.
View form guideNot sure which form applies?