To your clients, you are the gatekeeper to all that is Medicare. And as you know, that typically includes answering their questions about Original Medicare. UPMC for Life wants to make sure that you can continue to be the resource for your clients by giving you access to Part B enrollment information.
 
As a reminder, you can now request the Medicare Part B application forms through Cavulus to be sent directly to your clients in the mail.
 
To send the forms via Cavulus, choose “MC Part B App Kit” in the documents list. The forms will then be sent out to the beneficiary the next business day. They are available in both English and Spanish.
 
They can also be downloaded at the links below:

• Application for Enrollment in Part B (CMS-40B)
• Request for Employment Information (CMS-L564)

 
When advising beneficiaries to fill out the forms please note:

• If their employer can’t complete Section B, the beneficiary can fill it out. Their employer doesn’t need to sign the form. Instead, the beneficiary can send evidence of employment and health coverage, like health insurance cards with policy effective dates and pay stubs showing health insurance premium deductions. Get more information about evidence and filling out this form at SSA.gov/coronavirus.

• The beneficiary can send the forms (and evidence, if the employer can’t complete Section B) to the Social Security Administration one of these ways:
  • Mail to: the local Social Security office (you can find local Social Security offices by using the zip code lookup tool at https://secure.ssa.gov/ICON/main.jsp)
  • Fax to: 1-833-914-2016.

PLEASE DO NOT RESPOND TO THIS EMAIL OR FORWARD TO A BENEFICIARY. Emails sent to this email address, will not receive a response. If you have questions or need additional information, contact your broker manager.