Once you confirm that subscription, you will regularly This is a standard Department of Health and Human Services form it is for use by any Medicare enrollee who wants to stop receiving premium hospital (Medicare Part A) and Supplementary Medical insurance (Medicare Part B). During a long career in journalism, she has authored thousands of articles and two guidebooks on healthcare and social policy. An official website of the United States government or You can also fax the CMS-40B and CMS-L564 to 1-833-914-2016; or return forms by mail to your local Social Security office . You can reach Medicare at 1-800-MEDICARE (1-800-633-4227). It can also cover part-time home health services and physical therapy. Sign up to get the latest information about your choice of CMS topics. This is a read only version of the page. Accountant's Assistant: How long have you been receiving social security? Medicare is managed by the Centers for Medicare & Medicaid Services (CMS). The completion of this form is needed to document your voluntary request for termination of, Medicare coverage as permitted under the Code of Federal Regulations. Exhibit 1: CMS-1763 (Request for Termination of Premium Hospital and/or Supplementary Medical Insurance) HI 00820.902: EXHIBIT 2 - Form CMSL457 (Acknowledgement of Request for Medicare Part B Termination) TN 11 03-03: HI 00820.904: Exhibit 4: Notice to R-HI Beneficiary About Termination Because of Transplant . ","hasArticle":false,"_links":{"self":"https://dummies-api.dummies.com/v2/authors/9067"}}],"_links":{"self":"https://dummies-api.dummies.com/v2/books/282390"}},"collections":[],"articleAds":{"footerAd":"

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