Forms & Documents
Access important forms and documents for Medicare enrollment, VA benefits applications, and coordinating your healthcare coverage.
Medicare Forms
Essential forms for Medicare enrollment, plan changes, and appeals
Medicare Enrollment Application (CMS-40B)
Application for enrollment in Medicare Part B
Request for Employment Information (CMS-L564)
Request for employment information for Medicare enrollment
Medicare Redetermination Request Form
Request a redetermination of a Medicare claim decision
VA Benefits Forms
Forms for VA healthcare enrollment, disability claims, and benefits
VA Form 10-10EZ (Application for Health Benefits)
Application for enrollment in VA healthcare
VA Form 21-526EZ (Disability Compensation)
Application for disability compensation
VA Form 21-0966 (Intent to File)
Intent to file a claim for benefits
Medicare & VA Coordination
Forms for coordinating Medicare and VA benefits
Authorization to Disclose Personal Health Information
Allow sharing of information between Medicare and VA
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Medicare Part D Creditable Coverage Notice
Notice regarding prescription drug coverage
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