You may need documentation when enrolling in Medicare Part B, and Medicare may also need documents, such as medical reports, to assess claims. In each case, having the documents ready can prevent delays.

Most people do not need to present documentation to the Social Security Administration (SSA) when enrolling in Medicare, as enrollment can be automatic. However, if you do need specific documents, it can help to have them to hand, ready for submission.

Once your Medicare plan is set up, Medicare will typically manage your health claims directly with your healthcare team.

If you find that you need to submit a claim yourself, or if Medicare asks your healthcare team for further information, you may be required to send supporting documentation to Medicare so they can continue to assess the claim through to payment.

If you’re already receiving Social Security retirement benefits or Social Security Disability Insurance (SSDI), you will not need to provide any additional documentation to Medicare to enroll. The SSA and Medicare will have all the information needed to complete your enrollment.

If you do not receive Social Security benefits, you can contact the SSA to enroll during your initial enrollment period (IEP). If you do not enroll during your IEP, you may be able to enroll during a special enrollment period.

When enrolling, you may need to prove that you’re eligible for Medicare by providing certain documentation, which will often include:

  • your Social Security number
  • your date and place of birth
  • your citizenship status
  • the name and Social Security number of any applicable current or former spouse
  • the date and place of any applicable marriages or divorces
  • the names and ages of any children you have who are under age 18 years
    • If you have any children up to age 19 years who still attend high school, they will also need to be mentioned.
  • where applicable, the names and ages of any children you have who had a disability before age 22 years
  • whether you’ve ever applied for Social Security benefits before or whether anyone has ever applied for you
  • where applicable, the name and address of any employer you’ve had in the last 2 years
  • how much money you earned in the last 2 years
    • If you’re applying for Medicare between September and December, you’ll also need to estimate next year’s earnings.
    • If applicable, your W-2 or self-employment tax information from the past year.
    • If applicable, a record of your earnings, such as your Social Security statement.
  • where applicable, the dates of any military service you had prior to 1968
    • If you had military service before 1968, a record of your service, such as discharge papers, is necessary.
  • information about any railroad industry work carried out by you or a spouse
  • information about any Social Security work credits you may have earned in another country
  • information on any federal pension you receive now or that you will receive in the future

You may also need:

  • your original birth certificate or a copy certified by the issuing agency, such as the state in which you were born
    • If you don’t have your birth certificate, you can use other documents to prove your age, such as your immunization records, school records, state census records, insurance records, or medical records.
  • if applicable, proof of your U.S. citizenship, such as your U.S. passport, a Certificate of Naturalization, a Certificate of Citizenship, or a U.S. Consular Report of Birth Abroad
  • for non-U.S. citizens, proof of legal residency, including your Permanent Resident Card, usually called a Green Card, and your Arrival/Departure Record

Any documents you provide for your Medicare enrollment should be originals. The SSA will accept copies of W-2s, tax documents, and medical records, but everything else must be an original.

In all cases, either the SSA or the Railroad Retirement Board (RRB) handles Medicare enrollment. You can apply in the following ways:

You will not typically be required to file a claim under Medicare, as the law mandates healthcare professionals and facilities to bill directly for their services.

However, if you do need to file a claim, you can complete a claim form (which is also available in Spanish) and send it to Medicare directly.

The easiest way to do this is to make a claim package containing the following documentation:

  • your completed claim form
  • an itemized bill from your doctor, another healthcare professional, or facility, showing each service, item, or treatment that you received
  • a letter confirming why you have submitted the claim yourself. For example, if the healthcare professional or facility was unable or unwilling to bill Medicare directly
  • any supporting evidence from your healthcare team, such as a medical report

You should send the package to the address for the Medicare Administrative Contractor (MAC) relevant to your state, which is found on the claim form, pages 7 through 12.

Important information to include with your claim

If you submit incomplete or illegible claim documentation to Medicare for assessment, it may deny payment for usually covered services or items.

It’s important that you have sufficient documentation that confirms the treatment was “reasonable and necessary” and that it was medically essential to receive the items or services on the claim.

Your claim form and all information from your healthcare team should be complete, legible, and include:

  • reason for the visit
  • date you received the item or service
  • relevant medical history
  • test results
  • assessment, diagnosis, or both
  • treatment plan (if applicable)

If you need help with enrollment or submitting a claim, you can contact the State Health Insurance Assistance Program (SHIP) at 877-839-2675 or visit your local SHIP office.

Many people are automatically enrolled in Medicare, but if you are enrolling yourself, you may need to provide various documents to confirm your Medicare eligibility.

If you are already enrolled in Medicare, you should not need to submit a claim, as medical professionals and facilities are required by law to bill Medicare directly for their services.

However, if you do need to submit a claim, you can create a claim package, making sure to include a claim form and all relevant medical information relating to the claim, so that Medicare can make its assessment as quickly as possible.