Important Information On Medicare Payment For Flu Shots

Medicare pays for flu shots and other preventive services. Beneficiaries have two options available to them.

Option 1: Call your regular doctor to get a flu shot. If your doctor does not have flu shots available, you can go to any other doctor or provider who is enrolled in Medicare to get the flu shot. Your doctor will bill Medicare and you will pay nothing for the shot.

Option 2: Get a flu shot from a doctor or provider who is not enrolled in Medicare. You will have to pay for the shot when you get it, and Medicare will pay you back (about $18). Just follow these simple steps:

Step 1: Pay for your flu shot and get a receipt. The receipt must show

• Doctor/Provider Name
• Doctor Provider Address
• Service Provided ("Flu Shot")
• Date Service Provided
• Amount Paid

Step 2: Fill out Medicare's form #CMS-1490S, called "Patient's Request for Medical Payment." Mail the completed form and your original receipt to the Medicare Carrier in your State. For a list of Medicare Carrier addresses, please visit our FAQ: If I get a flu shot from a doctor or provider who doesn't bill Medicare, what should I do?

1. Fill out Boxes 1,2,3: With your name, HIC number and mailing address and phone number.
2. Skip Boxes 4 and 5.
3. Box 6: Sign and Date the Form. Please include receipt

Step 3: Medicare will mail you a payment in about three to four weeks. The amount of Medicare's payment varies by State, but is generally about $18. Please note that Medicare's payment could be less than the doctor or provider charged you for the flu shot.

Any questions? You can call your Medicare Carrier or 1-800-MEDICARE (1-800-633-4227) for answers to your flu shot questions.