| > | | | | and other specific facilities listed on the form. This |
| Medicare insurance is available to all American | | | | form is available for download from cms.hhs.gov |
| citizens who qualify for assistance. Once you are | | | | CMSforms/downloads/cms855b.pdf |
| qualified, there are specific forms you need to fill | | | | In order to get one of the above Medicare forms, |
| out and submit to be able to receive your | | | | copy the link that best applies to you, and then |
| benefits. | | | | paste it into your browser. After the link is in your |
| The U.S. government provides Medicare to | | | | address bar, press enter. |
| seniors, (which means, those over 65) and other | | | | For Individuals |
| people with specific medical problems. The Center | | | | Everybody over 65 is automatically eligible for |
| for Medicare Services (or CMS) executes the | | | | National health care. Other than that, you may |
| program. To take full advantage of it, visit your | | | | also be eligible for Medicare coverage if you've |
| health care provider for the right forms and to | | | | got a medical problem that's disabled you for at |
| get help with details on your application. | | | | least two years. Anybody who already receives |
| Contact your Social Security office to find out | | | | Social Security will automatically be enrolled in |
| more about the current Medicare requirements | | | | Medicare Parts A and B. Because Part B requires |
| for coverage, in that they tend to change with | | | | a premium payment, you may not want to |
| time. However, currently this is what Medicare | | | | include It in your application. Those that are |
| covers. | | | | automatically eligible for Medicare insurance (due |
| For Providers | | | | to their age) will be informed a couple of months |
| If you provide medical services and would like to | | | | before their 65th birth date about what they're |
| take part in the Government program, submit the | | | | going to need to start the process of registration. |
| CMS 10115 application form (this works well for | | | | If your eligibility for Medicare is based on need |
| most medical providers). Additional forms for | | | | rather than age based, you'll have to fill out an |
| medical providers are listed and discussed below. | | | | additional application to receive benefits. You can |
| 1. Form CMS 855A, Medical Enrollment Application | | | | get this application at the Social Security office. If |
| - Institutional Providers applies to: Critical Access | | | | you need assistance, you'll find a social security |
| Hospitals, Community Mental Health Centers, | | | | office at SocialSecurity.govĀ be on the lookout |
| Comprehensive Outpatient Rehabilitation Facilities, | | | | for the "Find a Social Security Office" link, which |
| Federally Qualified Health Centers, End-Stage Renal | | | | will bring you to the tool for locating an office. |
| Disease Facilities, and additional specific facilities | | | | Nobody can deny you coverage and benefits of |
| that are listed on the form. This application can be | | | | the National health care program. It is the United |
| downloaded from cms.hhs.gov/cmsforms | | | | States government's way of providing affordable |
| downloads/cms855a.pdf | | | | medical care for all seniors and badly ill citizens in |
| 2. Form CMS 855B titled Medicare Enrollment | | | | America. It's our means of guaranteeing a greater |
| Application - Clinics/Group Practices and Certain | | | | standard of universal health care, and our right to |
| Other Suppliers. It applies to Ambulance Service | | | | have open access to Government sponsored |
| Suppliers, Ambulatory Surgical Centers, | | | | insurance coverage. |
| Independent Clinical Labs, Clinic/Group Practices, | | | | |