Medicare Eligibility Tool

Copy of Initial Enrollment Period Package

You can view and print a copy of the Initial Enrollment Period Package online by accessing the links below. The Initial Enrollment Period Package includes important information about the decisions you need to make about whether to keep Medicare Part B or not.

Please note: This is just a sample of the Initial Enrollment Period Package and should not be used as your official Initial Enrollment Period Package. If you are already getting Social Security benefits, you will automatically receive the Initial Enrollment Period Package by mail 3 months before you become eligible. The Initial Enrollment Period Package will only be mailed to you if it is applicable to your situation and will not be mailed out to everyone. For further information, please contact Social Security at 1-800-772-1213. TTY uses should call 1-800-325-0778.

All of the documents are Adobe Acrobat version 5.0 accessible. You will need Adobe Reader software to view the files.

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People with visual disabilities can download tools and information at access.adobe.com to help make Adobe PDF files accessible.

1. Welcome to Medicare! a letter from the Administrator
2. Welcome to Medicare! a booklet that introduces you to the Medicare Program and explains some very important decisions you need to make.
3. Form CMS-40 The Complete Medicare Card Form (PDF: 366KB)