Filing a Claim

It is important to file claims properly. The following list will help:

  • Keep an accurate record of all your health care expenses. Store this information with your Medigap insurance or other health insurance policies.
  • Whenever you receive treatment, present your Medicare card and any other insurance card you have.
  • File all claims promptly. With each claim payment from Medicare, you will receive a Medicare Summary Notice (MSN). If the insurance company requests a copy of the Medicare Summary Notice, make a copy of the MSN and record the date you send the copy to the insurance company. Keep copies of any information you have concerning services received, the dates of services, and the persons who provided the services.
  • You do not have to submit your claims to Medicare. Your doctor, supplier, or other Medicare provider must submit claims to Medicare for you.
  • If you enroll in a health maintenance organization (HMO), you will not have to file claims for services covered by HMO providers. All claims for services covered will be handled by the HMO.
  • Some Medicare supplement insurance companies have an automatic claims filing program. This means that the insurance company gets claims directly from the Medicare fiscal intermediary. There may be a charge for this service.

For more information on filing claims, you may want to contact your county Elderly and Tribal Benefit Specialist.

NOTE: Under Wisconsin law, all Medicare supplement and Medicare select insurance policies must include a benefit appeal procedure for claim denials. This procedure will be explained in your policy and Outline of Coverage.