There is no address for all Medicare claims across the country. Instead, each state works with a Medicare Administrative Contractor (MAC) that handles the claims.
Original Medicare requires doctors and providers to submit claims for you within 12 months of the service you received.
Medicare Advantage does not use claims; it pays your doctor or provider monthly, and not by the service.
Your state may have a different Medicare claims address for medical services (doctors services, lab work, imaging) and equipment (durable medical equipment, prosthetics, etc.).
While it’s rare, you may need to look up your Medicare claims address at some point during your enrollment. If so, you’ll want to know your state’s Medicare claims mailing address, as well as what to include with your claim. Not knowing these basic details can leave you stuck paying the full amount instead of Medicare picking up its share.
Why is it rare to need a Medicare claims address?
Medicare is typically set up to take care of this for you. If you have Original Medicare (Parts A and B), your doctors and providers are required by law to submit claims to Medicare within 12 months of administering your service. With Medicare Advantage (Part C), plans pay your doctor or provider a monthly fee rather than requiring fee-for-service claims.
But there are cases when you may need to submit a claim yourself. If this happens, here’s how to find the Medicare claims mailing address you need.
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There is no central address that all Medicare claims are sent to. Each state works with a company called a Medicare Administrative Contractor (MAC) that handles medical claims for their geographic area. These companies process claims made on services covered by Medicare Part B like medical services, lab tests and imaging, vaccines and durable medical equipment.
Your specific Medicare claims mailing address can be found on your Medicare Summary Notice (MSN). Your MSN is sent out every three months and details the Medicare services you’ve received, and how much Medicare has agreed to pay for them.
If you need to file a claim and can’t find your MSN, here is your state’s Medicare claims mailing address:
If you’re submitting a claim for reimbursement, you’ll need to print off a Patient Request for Medical Payment form (CMS-1490S). You can fill it out online and print the form, or print and fill it out by hand. You’ll then mail the form and other necessary documents to your address above.
Why would I need to file a claim?
As we mentioned, you may not need to file a claim if you’re on Medicare. Most of your claims will be filed for you if you’re on Original Medicare, and most Medicare Advantage plans don’t use claims. But there are some situations you’ll need to know about.
If it’s approaching 12 months since you received a service and your doctor, provider or supplier still has not filed a claim. Call your doctor, provider or supplier to see if they will file the claim. If they are unable or refuse, you may need to file a claim yourself. Medicare suggests you call 1-800-MEDICARE (1-800-633-4227; TTY: 1-877-486-2048) to find out the exact date a claim must be received by.
If you receive care from a doctor or provider that doesn’t accept Medicare assignment. Medicare still may pay its portion, but you’re on your own to do the leg work.
You received medical care outside the U.S. Medicare will cover claims made in specific situations:
- You have a medical emergency while in the U.S. but a foreign hospital is closer than the nearest U.S. hospital.
- You have a medical emergency while traveling through Canada via the most direct route between Alaska and another state. If this happens and a Canadian hospital is closer than a U.S. hospital, Medicare may cover care at the foreign facility. These trips must be made “without reasonable delay,” which Medicare judges case by case.
- You live in the U.S. and the nearest foreign hospital is closer than the nearest U.S. hospital.
What do I need to include when mailing a reimbursement claim?
Along with the completed Patient Request for Medical Payment form, you’ll also need to include:
- The itemized bill or invoice from your doctor, healthcare provider or equipment supplier.
- A detailed letter explaining why the claim is being filed.
- Other supporting documents you think are related.
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No — if you have Medicare Advantage, all coverage decisions are made by the private insurer you purchased your policy from. So, if you have a Medicare Advantage plan through Company A, any claims you file will go to Company A and not Medicare. To find out how to file a claim through your insurance plan, call the company that provides your policy.
What is the Railroad Medicare claims address?
If you receive retirement benefits and Medicare through the Railroad Retirement Board, your claims are handled by a separate Medicare Administrative Contractor (MAC) — regardless of which state you live in.
Send paper claims and written correspondence to:
Palmetto GBA Railroad Medicare
P.O. Box 10066
Augusta, GA 30999-0001
To send claims, written correspondence and requested forms using private couriers or certified mail, use the following address:
Palmetto GBA Railroad Medicare
2743 Perimeter Parkway, Bldg. 200
Augusta, GA 30909