How to Submit a Claim to Medicare

Usually you do not have to submit a Medicare claim yourself. Your doctor or heath care facility is responsible for filing claims. However, there are certain circumstances that require you to submit a claim for reimbursement. For example, if you are traveling out of your coverage vicinity and need emergency treatment from a doctor not in your Medicare plan, you will likely be billed for service. Medicare will cover the treatment if your claim is approved.

Instructions

• 1

  Check the date services were received. Medicare typically requires claims to be filed within one full calendar year from the date of treatment. If a valid claim is filed after the allowed time period, it will be denied. For example, if you were treated on March 2010, your claim must be submitted by December 2011.

• 2

  Contact your doctor. Medicare recommends asking your doctor to file the claim on your behalf. If the doctor cannot file or you are approaching the time limit, proceed with filing the claim yourself.

• 3

  Go to the "How to File a Medicare Claim" section of the Medicare.gov website. Download the Patient's Request for Medical Payment form (see Resource).

• 4

  Fill out the form by providing your personal information. List your name, the claim number found on your insurance card, your address and your phone number.

• 5

  Describe the illness and treatment received. You will be asked to write a brief description and answer whether it was related to an automobile accident or to something that happened on the job.

• 6

  Answer questions if you have additional insurance coverage. If you or your spouse have a policy that covers you, provide the company name and policy number.

• 7

  Sign the form. Your signature authorizes the release of your medical records and information to Medicare.

• 8

  Attach the itemized bill. If you do not have a bill that itemizes treatment received, request it from your doctor.

• 9

  Mail the form along with your bill to your local Medicare carrier. If you need help obtaining the address or have any questions, contact Medicare by calling 800-Medicare.