My provider didn't file my Medicare claim. How do I file it myself, and by when?

Medicare.gov says you can file the claim yourself with the Patient Request for Medical Payment form (CMS-1490S) [1]. Generally you send [1]: • the completed CMS-1490S; • the itemized bill from your doctor, supplier or other provider; • a letter explaining why you're submitting the claim (for example, the provider can't file it, refuses to file it, or isn't enrolled in Medicare); and • any supporting documents, like notes from your doctor.

With Original Medicare, you mail these to the address for your state listed in the Medicare Administrative Contractor address table inside the claim form [1].

Medicare.gov says claims must be filed no later than 12 months (1 full calendar year) after the date the services were provided, unless an exception applies. If a claim isn't filed in time, Medicare won't pay its share [1]. With a Medicare Advantage plan and in-network providers, the providers usually submit the claim to your plan [1].

Help is available from your State Health Insurance Assistance Program (shiphelp.org) or 1-800-MEDICARE (1-800-633-4227) [1].