Forms & Resources

Sign Up for Medicare A & B

Use this link to sign up for Medicare A & B. Once you click on this link you will need to scroll down a bit on the page until you see the sign up for Medicare button! 


https://www.ssa.gov/medicare/sign-up


During the application you will be asked if you want to start your RETIREMENT BENEFITS, which term refers to taking your monthly Social Security check. 

Apply for Medicare Part B Only

If you are already enrolled in Medicare Part A and would like to enroll in Part B, you must complete this Application for Enrollment in Medicare – Part B (Medical Insurance).


Download form: https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/CMS-Forms-Items/CMS017339

Complete form online: CMS-40B


If you are applying for Medicare Part B due to a loss of employment or group health coverage, you will also need to complete a Request for Employment Information.

CMS-L564: https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/CMS-L564E.pdf

Complete form online: CMS-L564


You can also sign up online by going to the Medicare Sign Up page, and scrolling to the middle of page. 


 https://www.ssa.gov/medicare/sign-up


You can also fax the Employer Verification form to 1-833-914-2016; or return forms by mail or in person to your local Social Security office.   When completing the forms:


  • State, “I want Part B coverage to begin (MM/YY)” in the remarks section of the CMS-40B form or online application.
  • If your employer is unable to complete Section B, please complete that portion as best you can on behalf of your employer without your employer’s signature.
  • Submit one of the following types of secondary evidence by uploading it from a saved document on your computer:
  • Income tax returns that show health insurance premiums paid.
  • W-2s reflecting pre-tax medical contributions.
  • Pay stubs that reflect health insurance premium deductions.
  • Health insurance cards with a policy effective date.
  • Explanations of benefits paid by the GHP or LGHP.
  • Statements or receipts that reflect payment of health insurance premiums.


Sign up online (scroll to middle of page). https://www.ssa.gov/medicare/sign-up


Get Extra Help with Drug Costs

You should complete this application for Extra Help if:


  • You have Medicare Part A (Hospital Insurance) and/or Medicare Part B (Medical Insurance); and
  • You live in one of the 50 States or the District of Columbia; and
  • Your combined savings, investments, and real estate are not worth more than $35,130, if you are married and living with your spouse, or $17,600 if you are not currently married or not living with your spouse. (Do NOT count your home, vehicles, personal possessions, life insurance, burial plots, irrevocable burial contracts or back payments from Social Security or SSI.) If you have more than those amounts, you may not qualify for the Extra Help program. However, you can still enroll in an approved Medicare prescription drug plan for coverage.

 

EXCEPTION: Even if you meet these conditions, DO NOT complete this application if you have Medicare and Supplemental Security Income (SSI) or Medicare and Medicaid because you automatically will get the extra help.


https://www.medicare.gov/basics/costs/help/drug-costs



https://www.ssa.gov/medicare/part-d-extra-help

Medicare-Medicaid Savings Programs

Renew Your Medicaid

3 ways to renew your Medicaid eligibility


If you haven't received a notice from the Department of Children and Families (DCF) or you already renewed your Medicaid eligibility, no further action is needed.


  • Visit myflfamilies.com
  • Call the Department of Children and Families (DCF) at 850-300-4323, TTY 711, 7:00 a.m. - 6:00 p.m. ET, Monday-Friday
  • Mail completed documents to the address listed on your application


Caregiver Assistance Programs

The Department offers caregiver assistance services through various programs. The following are examples of programs that offer this service. You may call the Elder Helpline at 1-800-96-ELDER (1-800-963-5337) to find out if you or your loved ones are eligible to receive benefits and services from one or more of our programs.



Florida Social Services - Other Services

Florida Social Services also offers assistance in the form of food pantries, cash assistance, and lodging.  Find out more at:


https://www.findhelp.org/find-social-services/florida