Official Forms & Where to Find Them
Access official government forms and resources below. Many can be completed online, saved, printed, or emailed for your convenience.
Medicare Forms
Medicare Part B Enrollment (CMS-40B)
https://www.cms.gov/medicare/cms-forms/cms-forms/downloads/cms40b-e.pdf
How to get it:
Tap the link above
PDF opens Download or save Fill out or print
Backup: Go to www.Medicare.gov Use the search bar at the top
Type CMS-40B Select Application for Enrollment in Medicare Part B (CMS-40B)
Download the form
This works even when every direct link fails.
Request for Employment Information (CMS-L564)
https://www.cms.gov/medicare/cms-forms/cms-forms/downloads/cms-l564e.pdf
How to get it: Tap the link above
Download Have your employer complete Section B
Submit with your CMS-40B
Backup: CMS.gov → search CMS-L564
Medicaid & Medicare Savings Programs (MSP)
Florida ACCESS (Medicaid & MSP)
https://www.myflfamilies.com/medicaid
How to get it: Tap the link above
Select Apply for Benefits Create or log in to an account
Complete application
Backup (always works): Go to www.MyFLFamilies.com
Select Apply for Benefits
Choose ACCESS Florida
Create an account or log in Complete the application
Social Security (SSA)
Extra Help (LIS – Low Income Subsidy, Part D)
How to get it: Tap the link above
Select Apply for Extra Help
Complete online Save confirmation
Backup: SSA.gov → search Extra Help
Extra Help Paper Application (SSA-1020)
https://www.ssa.gov/forms/ssa-1020.pdf
How to get it: Tap the link above
Download PDF Fill out or print
Backup: SSA.gov/forms → search SSA-1020
Authorization to Disclose Information to a Third Party (SSA-3288)
https://www.ssa.gov/forms/ssa-3288.pdf
How to get it: Tap the link above
Download PDF Fill out
Backup: Go to www.SSA.gov Use the search bar Type SSA-3288
Open the form page and download
Veterans & VA Benefits
VA Health Care Application (10-10EZ)
https://www.va.gov/health-care/apply/application/introduction
How to get it: Tap the link above
Select Start Application
Complete online Save confirmation
Backup: VA.gov → search 10-10EZ
VA Pension / Aid & Attendance (21P-527EZ)
https://www.va.gov/find-forms/about-form-21p-527ez/
How to get it: Tap the link above
Download the form Fill out or print
Backup: VA.gov/find-forms → search 21P-527EZ
Aid & Attendance Medical Form (21-2680)
https://www.va.gov/find-forms/about-form-21-2680/
How to get it: Tap the link above
Download PDF Provider completes form
Backup: VA.gov/find-forms → search 21-2680
VA Caregiver Support Program
How to find help or apply:
Go to https://www.caregiver.va.gov
Select Apply for the Program of Comprehensive Assistance for Family Caregivers (PCAFC), or review the support options listed on the page Follow the instructions provided by the VA
Backup (always works): Go to www.VA.gov Use the search bar
Type Caregiver Support Program Select the official VA Caregiver Support result
Food & Utility Assistance
SNAP (Food Assistance) https://www.usa.gov/food-assistance
How to apply: Go to USA.gov/food-assistance
Select SNAP food benefits
Choose your state You'll be redirected to your state's official SNAP application
Backup (always works):
Go to www.USA.gov In the search bar, type SNAP Select Food Assistance / SNAP Choose your state
LIHEAP (Utility Assistance)
LIHEAP = Low Income Home Energy Assistance Program
https://www.acf.hhs.gov/ocs/low-income-home-energy-assistance-program-liheap
How to get it: Tap the link above
Find your state office Follow local steps
Backup: ACF.HHS.gov → search LIHEAP
Important Information & Disclosure
Anthony's Healthcare provides Medicare education and guidance only. We are not affiliated with or endorsed by the U.S. government, the federal Medicare program, the U.S. Department of Veterans Affairs (VA), or any state Medicaid agency, or any insurance carrier.
Medicare consists of multiple parts (Part A, Part B, Part C, and Part D), each with its own rules, costs, and coverage limitations. Medicare Advantage (Part C), Prescription Drug Plans (Part D), Medicare Supplement (Medigap) policies, and Special Needs Plans (D-SNP, C-SNP) are offered by private insurance companies that are approved and regulated by Medicare.
Coverage, premiums, deductibles, copayments, coinsurance, provider networks, formularies, service areas, and extra benefits may vary by plan, carrier, county, and contract year and are subject to change. Extra benefits such as dental, vision, hearing, fitness programs, transportation, over-the-counter allowances, food or grocery benefits, meals, and in-home services are not guaranteed and may have limitations or eligibility requirements.
We do not offer every plan available in your area. Any information we provide is limited to the plans we do offer. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all your options.
Information provided is for educational purposes only and does not guarantee eligibility, coverage, or enrollment.
Forms linked on this page are provided for educational and convenience purposes only. Anthony's Healthcare is not affiliated with or endorsed by Medicare, Medicaid, the Social Security Administration, the U.S. Department of Veterans Affairs, or any other government agency referenced here. We do not control these government websites and are not responsible for changes to their forms, links, or availability; eligibility for any program is determined solely by the administering agency. Plan discussions occur only after a Scope of Appointment is completed.