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You searched for: Where can I get the forms I need to appeal Medicare coverage decisions?


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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.
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