Health insurance guide
CMS-1490S Medicare claim guide (when beneficiaries should file)
CMS-1490S is used by Medicare beneficiaries to request payment directly when a provider or supplier did not submit a claim. This guide explains when to use it and how to prepare a complete packet.
Published Feb 20, 2026
How it works
Fill out form
Complete the guided fields online.
Preview PDF
Review the generated PDF before mailing.
We print and mail it via USPS.
Key takeaways
- CMS-1490S is for specific beneficiary-filed claim situations.
- You still need supporting documentation, especially an itemized bill.
- The completed packet is mailed to the correct Medicare Administrative Contractor.
- Keeping a copy of your full submission helps with follow-up.
When to use CMS-1490S
CMS-1490S is generally used when:
- A provider or supplier refused to file a claim for Medicare covered services.
- A provider or supplier was unable to file a claim for Medicare covered services.
- A provider or supplier is not enrolled with Medicare.
Check the current form instructions before filing so you use the correct process for your claim type.
What to gather before filling the form
Prepare these items first:
- Your Medicare card details (name and Medicare number as shown).
- Date of birth and current contact information.
- Illness or injury details and treatment summary.
- Itemized bill(s) from providers or suppliers.
- Other insurance details if Medicare is not primary.
If you are signing on behalf of the patient, gather witness and relationship details too.
How to complete CMS-1490S
- Choose the claim-submission reason and request type.
- Enter patient identifying details exactly as shown on the Medicare card.
- Describe services received and whether the condition was employment, auto, dialysis, or other accident related.
- Complete other-insurance fields when additional medical coverage exists.
- Sign and date the form, or complete the witness section when the patient cannot sign.
Where to mail CMS-1490S
Mailing addresses depend on your Medicare Administrative Contractor and claim context. Use the latest contractor address table and instructions referenced by Medicare before mailing.
Do not rely on old screenshots or third-party address lists for final destination details.
Common mistakes
- Leaving reason-for-submission checkboxes blank.
- Missing required supporting itemized bills.
- Omitting other-insurance information when secondary coverage exists.
- Missing patient signature/date or incomplete witness section.
- Mailing to the wrong Medicare contractor address.
Sources
FAQs
- Can I use CMS-1490S for any Medicare payment issue?
- No. It is intended for specific beneficiary-filed claim scenarios described in the form instructions.
- Is an itemized bill required?
- In most cases yes. The form instructions call for detailed supporting documentation.
- Should I include primary insurance documents?
- If Medicare is secondary, include primary insurer documentation such as an EOB when available.
- How long should I wait after mailing?
- Medicare materials indicate processing can take time, so keep copies and allow adequate processing time before escalating.
Ready to send it?
Complete CMS-1490S, attach supporting documents, and mail the packet in one workflow.