By David S Edge

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How do I file a claim with Medicare?

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If you have a Medicare Advantage plan you receive all your medical care from your network that you signed up for. You should never have to file a separate claim for reimbursement directly from Medicare. Simply pay any required co-pays on your plan to your medical provider.

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However, if you have Medicare with a Medigap (Supplement) plan, you will find most medical providers participate in Medicare and will file your paperwork or claims for you. There are a much smaller percentage of medical providers who do not participate in Medicare. This is when you may need to do the paperwork yourself.

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Non-participating medical providers may want you to pay them for services rendered at the time of your service. You will take the bill and fill out a “Patient’s Request for Medical Payment” form that you can get at Medicare’s website at www.medicare.gov. You will mail the completed claim form directly to Medicare. You will call 1-800-Medicare to find out the address to your local Medical billing office.

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On Medicare’s website, look on the top right side of the screen and click on the “Forms, Help, & Resources” tab.

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Next, select the tab on the left titled Medicare Forms. The page will open to several options. Select I want to file a claim for services.

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In the paragraph that opens, select the first option in the opening sentence “Patient Request for Medical Payments form”.

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The screen will change and be titled Details for title: CMS 1490S. Scroll down and select the very first item on the list; CMS 1490S- English. You will also see the option of a Spanish version of the form.

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The second selection on the list is direction on how to fill out the form. You can print this as well.

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The form is simple and requires your name, Medicare ID number, male or female, your mailing address, and a brief explanation of why you received this medical service. Attach a copy of the bill, and follow the mailing instructions.

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You will receive a payment from Medicare for their portion of the submitted bill, and a second payment for the balance of the bill will be sent to you by your Medigap carrier.