U.S. Department of Health and Human Services - Centers for Medicare and Medicaid Services Forms




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This application is supposed to be used by individuals when they want to apply for enrollment in Medicare Part B, insurance which provides outpatient medical coverage.

This is a document developed for nursing facilities which are supposed to be filed during standard or extended health surveys.

This is a legal document which must be completed to prove the group health plan coverage based on your or your spouse's current employment.


File this form to document that the use of the medical equipment used for enteral nutrition is justified. This part of the procedure is called the medical necessity, which is a way to have Medicare compensate the costs of items and services that are considered necessary.

This form is filled out by the patient's attending physician and used as a fiduciary document in order to authorize professional health services.

This is a legal document that any Medicare enrollee may use to terminate hospital insurance and supplementary medical insurance. This form was released by the U.S. Department of Health and Human Services.

This application is a legal document used to apply for and enroll in Marketplace health coverage with the DHHS.

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