Filing a claim

Page last updated on: 4/07/25

Use these forms to file a claim or file for reimbursement for your Medicare drugs and services.

Medicare medical reimbursement

Medical claim reimbursement form

Part D drug claim reimbursement

Part D drug claim reimbursement form

Part D drug claim reimbursement form - Spanish

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Priority Health has HMO-POS and PPO plans with a Medicare contract. Enrollment in Priority Health Medicare depends on contract renewal. This information is not a complete description of benefits. Call 888.389.6648, option 3 (TTY users call 711) for more information.