GUIDE FOR CARE AND SUPPORT DURING SERIOUS ILLNESS
Chapter 4: The Health Care System: Piecing it all together
Insurance Information
The coverage of your care and treatment is often paid for by different types of medical insurance, as well as yourself. With numerous bills, it is often helpful to keep a record of what payments have been made, to whom, and in what amounts. If you have any questions regarding a bill, contact the health care provider and your insurance company.
The toll free number for the Medicare Hotline is: 1.800.638-6833. The web site is: www.medicare.gov. Each state has its own Medicaid hotline. In Washington, it is 1.800.562.3022. Many providers will need your social security number, birthday, and driver's license number to process claims.
General Information
Social security number: _____________________________________
Birthday: _______________ Driver's license #: __________________
Medicare number: ______________ Medicaid number:_____________
Other I.D.: ________________________________________________
Insurance Providers
Primary Insurance Name: ____________________________________
Customer service phone number: _____________________________
Identification number: ______________ Group number: ___________
Address: _________________________________________________
Contact person(s): _________________________________________
Secondary Insurance Name: _________________________________
Customer service phone number: _____________________________
Identification number: ______________ Group number: ___________
Address: _________________________________________________
Contact person(s): _________________________________________
Notes
Created by Compassionate Choices.