Those enrolled in Original Medicare are not required to file their own claims for covered services as this is done by doctors and suppliers. Beneficiaries with a Medicare Advantage Plan, or Part C, you don't have to file a claim because the private insurance companies receive payments of specific amounts from Medicare each month.
The only time a claim will need to be file by individuals with Medicare is in very rare cases such as when your doctor or health care provider does not submit the claim on your behalf. When a claim is filed, it must be done no later than 12 months or one full calendar year after the date the services were provided.
This is when you'll want to check your Medicare Summary Notice that's issued to you every three months to ensure your claims are being filed on time. If you see errors, you should contact your doctor or supplier and ask them to file the claim. After speaking with your service provider and you find a claim has not yet been submitted, then you can call 1-800-MEDICARE and ask for a time limit to submit the claim and if that limit is getting closer then you can do it yourself.
Beneficiaries can file a claim by filling out the Patient Request for Medical Payment form. A patient who wants someone else to call on their behalf must also fill out an Authorization to Disclose Personal Health Information form so that Medicare can talk to and give your personal information to someone other than the listed beneficiary.