MEDICARE PART B Part B Individual Enrollment Form (CMS 40B) Get Started MEDICARE PART B Part B Request for Employment Information (CMS L564) Get Started IRMAA Medicare Income-Related Monthly Adjustment Amount - Life-Changing Event Get Started MEDICARE SAVINGS PROGRAM Medicare Savings Program Application Get Started APPOINTMENT OF REP Medicare Appointment of Representative form Get Started EPIC EPIC Application Get Started FINANCIAL ASSISTANCE Rochester Regional Health Financial Assistance Application Get Started FINANCIAL ASSISTANCE University of Rochester Financial Assistance Application Get Started PART A & B Request For Termination of Medicare Get Started