CMS-40B Enrollment Screenshots
Application for Enrollment in Medicare Part B (Medical Insurance) (CMS-40B)
Enrollment Screenshots for CMS-40B
Application for Enrollment in Medicare Part B (Medical Insurance)
OMB: 0938-1230
Document [docx]
Download: docx | pdf
SEP Screenshots
HIHI Screen
Landing Page with no prior SEP occurrences
Landing Page with 1 prior SEP occurrence
Landing page with 2 prior SEP occurrence
Add SEP Page prior to SEP selection
Add SEP with International Volunteer Selected
Add SEP Page with Other (United States Postal Service) Selected
Edit SEP Page when an existing SEP is edited
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Todd Owens |
| File Modified | 0000-00-00 |
| File Created | 2025-05-19 |
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