How to fax it
- Fill in and sign CMS-40B. In the remarks, write “I want Part B coverage to begin (MM/YY)”.
- Special enrollment period? Add CMS-L564 with Section B completed by your employer, plus proof of your group health coverage.
- Find your local office’s fax at ssa.gov/locator (Office information › Contact numbers › Fax).
- Send it from dimefax.com/send.
- Keep the delivered confirmation. Dimefax shows the date and time it went through.
Tips
- You can also apply online at ssa.gov and upload the forms and evidence, or call 1-800-772-1213.
Dimefax costs 10¢ a page and you’re only charged if the fax goes through. On the web, page credits come in packs of 50 for $4.99, 100 for $9.99 or 200 for $19.99; the Dimefax iPhone app also sells 10 for $0.99. Credits you don’t use stay in your account and last as long as you fax once a year.
Where these numbers come from
Dimefax isn’t part of, or endorsed by, the Social Security Administration. We copied these numbers from ssa.gov on November 11, 2026. Agencies change their numbers: if your letter, notice or form gives a different one, use that.