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When you have Medicare, you’ll fill out at least one form. Forms are necessary for enrollment, appeals, and change of authority. Most documents you can find online by downloading the PDF file. Below we’ll discuss the forms you need, how to find them, and where to submit them.
An Explanation of Medicare Forms
Applying for Medicare seems challenging when you’re unfamiliar with the process. The variety of forms can be even more confusing than the Medicare enrollment periods. Well, we have all the details you need to get through Medicare successfully.
Initial Medicare Enrollment Forms
Medicare Application Form
Medicare Opt-Out Forms
Medicare Part A Application Form
Part B Forms
If you already have Part A and want to enroll in Part B, you’ll need to complete the CMS-40B form. Now, if you lost Employer coverage, you’ll need to fill out the CMS-L564 Request for Employment Information. You can fill these forms out online, via fax, or send it by mail.
Medicare Part A and Part B Termination Form
If you want to terminate Part A or Part B, you’ll need to fill out the CMS 1763 form. Medicare isn’t Mandatory, but, if you don’t have creditable coverage, you may risk penalties in the future. To Terminate Part B you’ll need to file the CMS-L457 form to acknowledge your request for termination. Further, the form for Part A is the CMS-L458, you’ll fill out this for to acknowledge your request for termination.
Request for Employment Information
To prove you have creditable coverage from an employer or employer group plan, you’ll fill out the CMS-L564 form to prove your eligibility for a Special Enrollment Period.
Part C Scope of Appointment Form
Part C Application Form
Medicare Part D Forms
Easy Pay Form
Medicare Authorization Form to Disclose Personal Health Information
Medicare Claim Forms
You may be wondering how to file a Medicare claim. First, it’s unlikely that you’ll have to submit your Medicare claim. Most doctors have a medical billing and coding office that will file claims for you. But, in the rare case you do need to fill out a claim form, you’ll fill out the Patient Request for Medical Payment form (CMS-1490S)
Third-Party Premium Billing Request Form
You can designate a family member or friend to pay Medicare premiums, this is a third-party payer. Then, if Medicare approves the request, premium bills will be sent to the person you designate as the payer. The form is a CMS-2384 third-party premium billing request form. Once you submit this form, Medicare will make a decision.
Medicare Reimbursement Form
Medicare Grievance Forms
Note: Appeals are when you don’t agree with Medicare’s coverage decisions. Complaints are related to treatment and quality of service.
Medicare Appeal Form
Consent for Home Visit Form
Medicare Wellness Exam Form
How to Get with Your Medicare Supplement Application Form
Our agents will happily help you identify the best coverage options in your area and then walk you through the Medigap application form. We are here to help guide you on your Medicare journey. Give us a call at the number above to get help filling out your Medicare Supplement application form. Or, compare rates online to see your options now.