- A claim is a request for payment for medical services or supplies that a beneficiary has received. If a beneficiary is enrolled in Medicare, they or their healthcare provider may need to submit a claim to Medicare to request payment for covered services.
- There are several ways to submit a Medicare claim, depending on the type of service or supply a beneficiary has received. For example, if a beneficiary has received inpatient hospital care, their hospital will typically submit a claim to Medicare on their behalf. If a beneficiary has received outpatient medical services or supplies, their healthcare provider may submit a claim to Medicare, or they may be required to submit the claim themselves.
- It is important to note that Medicare may not cover all medical services and supplies, and a beneficiary may be responsible for paying some or all of the cost out-of-pocket. It is a good idea to discuss coverage and any potential out-of-pocket costs with a healthcare provider before receiving medical care, to ensure that a beneficiary may understand what is covered by Medicare and what they may be responsible for paying.
- If a beneficiary has any questions about submitting a Medicare claim or about their Medicare coverage, it is recommended that they contact their Medicare plan or speak with a Medicare representative.
