1. Member Sections

Deadline Details

Medicare Enrollment Application Revised
The CMS-855I form, revised in December 2018, is available for use now. After April 30, Novitas Solutions and the other Medicare administrative contractors will accept only this new version. You can identify the new form by the header on page two, which says: “Form Approved OMB No. 0938-1355 Expires: 12/21.”
CMS and Novitas
05/01/2019
Use of the old form after April 30 will result in a denial of the old form and a possible delay in processing a Medicare enrollment application.
Use of the old form after April 30 will result in a denial of the old form and a possible delay in processing a Medicare enrollment application.
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