Looking for a Medicare form?
We may just have what you are looking for. Medicare forms allow you to sign up for Medicare, to end your Medicare coverage, to dispute a payment decision, to consent to a home a visit, and more. Below you will find a variety of Medicare forms, including a Medicare appeal form, Medicare opt-out form, and Medicare complaint form. These forms and additional information can be found on the Centers for Medicare & Medicaid Services website at Medicare.gov. Once completed, review the Instructions section of the form to return the form to the appropriate government agency. The forms should not be mailed or returned to eHealth or your health plan.
For many of these Medicare forms you will need to provide your Social Security number or Medicare number, so be sure you have these numbers available. Some forms may also ask for your date of birth and address. In some cases you may be asked to provide supporting information, such as an itemized bill from a doctor’s office, outpatient hospital, or nursing home. In the case of an appeal, you may attach supporting evidence that will support your appeal. Most Medicare forms require a signature. For beneficiaries who sign by mark (X), at least one witness is required to also sign the form.
These forms can also be found on www.medicare.gov