If you received a bill for medical services or if you paid for medications that should be covered by the plan, you can request that we pay for the invoice or request a reimbursement.
Send us your request for payment, along with your bill and/or documentation of any payment you have made. Even if it is not a requirement, we suggest you fill out our claim form to make your request for payment. This form, which you can find below, will help us process the information faster, with all the information we need to make a decision. It’s also a good idea to make a copy of your bill and receipts for your personal records.
Download and complete the form according to your plan for medical services reimbursement. Once the form is completed, send your request for payment of medical services along with any invoices or receipts by mail to the following address:
Download and complete the form according to your plan for a pharmacy reimbursement. Once the form is completed, send your request for pharmacy reimbursement along with any invoices or receipts by mail or fax to the following address:
You can also submit your application by visiting any of our Service Offices.
You must submit your claim within a period of 12 months from the date when you received the service, item, or medication. When the request arrives to the plan, it must be processed within 14 calendar days. If the plan’s decision is favorable to you, the plan must make the payment within a period of 14 calendar days after receiving the request.
For more details on how to submit a claim in writing, you can refer to the Claims Process that is explained in Chapter 9 of the Evidence of Coverage of your plan.
For more information or help in submitting your request, you can contact Member Services.
Medicare y Mucho Más (MMM) (HMO), PMC Medicare Choice (PMC) (HMO) and FIRST+PLUS (PPO), products offered by MMM Healthcare, LLC, are plans with a Medicare contract. Enrollment in the plans depends on contract renewal. To enroll, you must have Medicare Parts A and B, have not been diagnosed with End Stage Renal Disease (ESRD) and reside within the 78 municipalities of the Island. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premium and/or co-payments/co-insurance may change on January 1 of each year. You must continue to pay your Medicare Part B premium. The Formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary. Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next. MMM Healthcare, LLC complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. MMM Healthcare, LLC cumple con las leyes federales de derechos civiles aplicables y no discrimina por motivos de raza, color, nacionalidad, edad, discapacidad o sexo. ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame a MMM al 1-866-333-5470, (TTY: 1-866-333-5469); PMC al 1-866-516-7700 (TTY: 1-866-516-7701); y First+Plus al 1-888-767-7717 (TTY: 1-877-672-4242). MMM Healthcare, LLC遵守 用的 邦民 法律 定，不因 族 適聯權規種色、民族血 、年 、 障 或性 而歧 任何人。注意：如果您使用繁 中文，您可以免 得 言援助服 。 致 膚統齡殘別視體費獲語務請電MMM 1-866-333-5470, (TTY: 1-866-333-5469); PMC 1-866-516-7700 (TTY: 1-866-516-7701); First+Plus 1-888-767-7717 (TTY: 1-877-672-4242).
H4003-MMM Healthcare, LLC H4004-PMC Medicare Choice H7522-MMM Healthcare, LLC Y0049_2018 4006 0001 1 CMS Approved 10042017
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