Medicare Forms
Sign up for Part B
Application for Enrollment in Medicare Part B (Medical Insurance) »
- What’s the form called?
- Application for Enrollment in Part B (CMS-40B)
- What’s it used for?
- Signing up for Part B when you already have Part A.
Give proof of employment when you sign up for Part B
- What’s the form called?
- Request for Employment Information (CMS-L564)
- What’s it used for?
- Giving the Social Security Administration proof you’re eligible to sign up for Part B if:
- You’re still working.
- You retired within the last 8 months.
- You lost job-based health coverage within the last 8 months.
Medicare Income-Related Monthly Adjustment Amount – Life-Changing Event
- If you had a major life-changing event and your income has gone down, you may use this form to request a reduction in your income-related monthly amount.
Change my Banking Information with United American
Florida Retirement System
- Insurance Payroll Deduction Authorization Form
Reserve Fund Annuity Transaction Form
- Make a deposit to or withdrawal from your Reserve Fund Annuity