Application for Enrollment in Part B Immunosuppressive Drug Coverage (Part B-ID) (CMS-10798)

The CMS-10798 provides the necessary information to determine eligibility and to process the beneficiary’s request for enrollment for in Part B-ID coverage. This form is only used for enrollment by beneficiaries whose Medicare entitlement based on ESRD would otherwise end after a successful kidney transplant to continue enrollment under Medicare Part B only for the coverage of immunosuppressive drugs who already have Part A, but not Part B.

The latest form for Application for Enrollment in Part B Immunosuppressive Drug Coverage (Part B-ID) (CMS-10798) expires 2028-12-31 and can be found here.