Medicare Appeals Forms
Source: United States Department of Health and Human Services, Centers for Medicare and Medicaid Services
Links to online forms people can use in Medicare-related appeals. Forms include: Appointment of Representative, Request for Review of Part B Medicare Claim, Request for Hearing - Part B Medicare Claim, Request for Reconsideration of Part A Health Insurance Benefits, Request for Part A Medicare Hearing by an Administrative Law Judge, and Request for Part B Medicare Hearing by an Administrative Law Judge. Some forms are available in Spanish. Special tools are also provided to permit access to the forms by persons with visual disabilities.