How do I file a claim?
Fill out the claim form, called the Patient Request for Medical Payment form (CMS-1490S) [PDF, 52KB). Follow the instructions for the type of claim you're filing:
Fill out the claim form, called the Patient Request for Medical Payment form (CMS-1490S) [PDF, 52KB). Follow the instructions for the type of claim you're filing:
- Claims for Part B services -use these instructions [PDF, 205KB].
- Claims for durable medical equipment (DME) - use these instructions [PDF, 162KB].
- Claims for shipboard services (medical services you got aboard a ship) - use these instructions [PDF, 143KB].
- Claims for services you got in Canada or Mexico - use these instructions [PDF, 148KB].
- Claims for services you got in a foreign hospital - use these instructions [PDF, 149KB].
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