The Medicare web page now includes Medicare forms that
can be downloaded and used by beneficiaries and advocates when filing Medicare
appeals. The Centers for Medicare and Medicaid Services (CMS) added the forms to
the Medicare web page after years of requests by Medicare advocates.
To get to the forms, go to
and then click on Medicare Basics. Then scroll down the list of topics and click
on Medicare Appeals Forms. The forms are available in PDF format.
So far, the site includes the following forms:
Appointment of Representative Form
Request for Review of Part B Medicare Claim
Request for Reconsideration of Part A Health Insurance
Request for Part A Hearing by an Administrative Law Judge
The site also includes forms and instructions for Medicare+Choice Notices:
Other forms to be added to the site in the future include: