MEDICARE BENEFICIARY E-MAIL INQUIRY
While we have provided the answers to many general questions in our Frequently Asked Questions, Medicare beneficiaries can use the form below to ask additional questions of a general nature.

NOTE: Because of privacy concerns, questions related to specific claims or your Medicare eligibility should not be sent by e-mail. Please do not include personal information such as your Medicare number. For information on your claim, or your Medicare eligibility, please call the number on your Medicare Summary Notice. (Additional information about Medicare Summary Notices.)
Medicare Beneficiary Inquiry Form
(* fields required)
*Beneficiary Name:
*Inquirer's Name:
(if other than Beneficiary)
*Phone Number:
(Please include area code)
Fax Number:
(Please include area code)
E-Mail Address:
*Inquiry

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