Here's my situation. When I first got Medicare Part A and Part B, I had zero guidance. Plus I was in the throws of a divorce and having to find a place to live. I never saw anything from Social Security that my Part B premiums were not being paid. My Medicare Part B lapsed and I was told that I need to fill out a SSA-795 to get it reinstated. Now I own a fine that is beyond my ability to pay to be reinstated (upwards of $600).
--> I am looking for examples of what to say in SSA-795 form's declaration to Social Security asking them to be reinstated.

Hi,

I don't know the specifics of your case, but if your Part B coverage was terminated due to failure to pay premiums and you're trying to get Part B coverage reinstated, you would want to explain to Social Security why you didn't pay your premiums. For example, maybe you didn't realize that the premiums were due for some reason, etc. However, Social Security won't reinstate your Part B coverage unless you pay any premium arrearage due. For specifics about this process, refer to the following section of Social Security's operations manual: https://secure.ssa.gov/apps10/poms.nsf/lnx/0601001295.

If you can't get your Part B coverage reinstated but you still meet the coverage requirements, you can re-enroll during a general enrollment period (GEP). The next GEP runs from January through March of next year, and if you sign up during that time your coverage would resume on July 1st of next year.

Best, Jerry