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How do I submit a Medicare claim (bill)?

How do I submit a Medicare claim (bill)?

If you are in the Original Medicare Plan, providers (eg: hospitals, skilled nursing facilities, home health agencies, physicians, pharmacies, and suppliers) that are enrolled in the Medicare program are required by law to file Medicare claims for covered services or supplies you receive from a provider that is enrolled in the Medicare program. You should not need to file any Medicare claims. Important: Ask the pharmacy or supplier if it is enrolled in the Medicare Program. If you go to a pharmacy or supplier that is not enrolled, Medicare will not pay. You will be responsible for paying the entire bill for any drugs or supplies. Medicare claims must be filed within one full calendar year following the year in which the services were provided. For example, if you see your physician on March 22, 2009, the Medicare claim for that visit must be filed by December 31, 2010. Note: This information on filing a Medicare claim only applies if you are in the Original Medicare Plan. If you get your Medicare health care through a managed care plan (like an HMO) or a Private Fee-for-Service Plan, Medicare claims are not filed. Medicare pays these private insurance companies a set amount every month. Therefore, they do not need to file Medicare claims. Information about when and how to file a Medicare claim.

FAQ_Category: 
General Medicare Information