How Do You Make a Medicare Claim?


Quick Answer

To file a Medicare claim, complete the Patient Request for Medical Payment form, titled CMS 1490S, available on CMS.gov, instructs Medicare.gov. Mail the form to your Medicare carrier, and provide the requirements specified in the downloadable form.

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Full Answer

To determine the address of your Medicare carrier, view the Downloads section on the CMS 1490S page of CMS.gov, then click on any of the links with "Instructions” in the title, states Medicare.gov. Alternatively, check your Medicare Summary Notice, or log in to MyMedicare.gov to view a digital copy of your MSN. If you want to authorize someone to access your personal information, complete the Authorization to Disclose Personal Health Information form.

There is no need to file a claim if you are under Original Medicare, because doctors and suppliers are responsible for filing Medicare claims as mandated by the law, notes Medicare.gov. If you are enrolled in a Medicare Advantage Plan (Part C), filing a claim is also not necessary, as Medicare pays a fixed monthly amount to private insurance companies.

You may opt to file a Medicare claim if your doctor or supplier fails to do so before the deadline, says Medicare.gov. As of 2015, the toll-free number to call if your doctor does not make a claim is 1-800-MEDICARE. You can inquire about exact deadlines and ask pertinent questions. Health care providers must file a claim within a full calendar year following the date of providing medical services.

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