Form SSA-1: Application for Retirement Insurance Benefits
Use this form to apply for Social Security retirement benefits.
Submitting it starts your monthly retirement payments.
Useful Forms
Click below to download the form you'd like for FREE.
Social Security Forms
Form SSA-2: Application for Wife’s, Husband’s, or Ex-Spouse’s Insurance Benefits
Use this form to apply for spousal or divorced spousal Social Security benefits.
Submitting it starts your spousal benefit payments.
Submitting it starts your spousal benefit payments.
Form SSA-4: Application for Child’s Insurance Benefits
Use this form to apply for Social Security benefits for a child based on a parent’s record.
Submitting it starts the child’s benefit payments.
Form SSA-10: Application for Widow’s or Widower’s Insurance Benefits
Use this form to apply for Social Security survivor benefits as a widow or widower.
Submitting it starts your survivor benefit payments.
Form SSA-16: Application for Disability Insurance Benefits
Use this form to apply for Social Security Disability Insurance (SSDI) benefits.
Submitting it begins the disability benefits review process.
Submitting it begins the disability benefits review process.
Form SSA-8000: Application for Supplemental Security Income (SSI)
Use this form to apply for Supplemental Security Income (SSI).
Submitting it starts the SSI eligibility process.
Submitting it starts the SSI eligibility process.
Form SSA-521: Request for Withdrawal of Application
Use this form to withdraw a previously filed Social Security application.
Approval allows you to cancel your claim and reset your filing decision.
Form SSA-634: Request for Change in Overpayment Recovery Rate
Use this form to ask Social Security to lower the amount being withheld each month for an overpayment.
Submitting it requests a review based on your financial situation.
Medicare Forms
Form CMS-40B: Application for Enrollment in Medicare Part B (Medical Insurance)
Use this form to enroll in Medicare Part B.
Submitting it starts your Part B coverage.
Form CMS-L564: Request for Employment Information
Use this form to verify employer group health coverage when enrolling in Medicare Part B.
It helps confirm you qualify for a Special Enrollment Period and avoid late penalties.
Form SF-5510: Enroll in Medicare Easy Pay – Automatic Premium Withdrawal
Use this form to set up automatic Medicare premium payments from your bank account.
It helps ensure your premiums are paid on time.
Form SSA-44: Income-Related Monthly Adjustment Amount (IRMAA) Appeal
Use this form to request a reduction in your Medicare Part B and Part D premiums after a qualifying life-changing event.
Submitting it starts the IRMAA appeal review process.
Form CMS-1763: Application for Termination of Medicare Part A and/or Part B
Use this form to request cancellation of your Medicare Part A and/or Part B coverage.
Approval stops your Medicare coverage moving forward.
Form CMS-10287: File a Complaint About the Quality of Healthcare You Received
Use this form to report concerns about the quality of care from a Medicare provider.
Submitting it starts a formal review of your complaint.
Form CMS-1490S: File a Medicare Claim
Use this form to request Medicare reimbursement for covered services when a provider does not file the claim for you.
Submitting it starts the payment review process.
Assistance & Savings Programs
Form SSA-1020: Application for Extra Help with Medicare Prescription Drug Plan Costs
Use this form to apply for Extra Help with Medicare Part D prescription drug costs.
It helps reduce premiums, deductibles, and copays if you qualify.
Medicare Savings Program (MSP): Model Application for Medicare Premium Assistance
Use this application to apply for state assistance with Medicare premiums and, in some cases, deductibles and coinsurance.
If approved, it can lower your overall Medicare costs.
If approved, it can lower your overall Medicare costs.
SHIP: State Health Insurance Assistance Program (Find Local Help)
Use SHIP to get free, unbiased help with Medicare questions and enrollment.
Local counselors can guide you through your coverage options.