If people are enrolled in Original Medicare (Medicare Hospital Insurance (Part A) and Medicare Medical Insurance (Part B)), they should not need to file any Medicare claims. Their plan providers (doctors, hospitals, skilled nursing facilities, home health agencies, pharmacies and suppliers) are required by law to file claims for covered services or supplies.
Before using a provider’s services or supplies, beneficiaries should be sure to check that the provider is enrolled in the Medicare program. If the provider is not enrolled, Medicare will not pay the charges and the beneficiaries will be responsible for paying the entire bill.
People may have to file a claim in only very rare occasions.
People will get an Explanation of Benefits, showing bills paid on their behalf. This is just information for beneficiaries — it is not a bill for payment.
If people have Medicare Advantage Plans (Part C), they do not have to file claims because Medicare pays the private companies a set amount each month.
Who Runs Medicare?
What is the Medicare Initial Enrollment Period?
How Does a Person Apply for Medicare?
How Do People Submit a Medicare Claim or Bill?