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Put down the information in the For More Information About Your, • Visit www, “Medicare, You”, handbook for, their, telephone, number), for, your, copy of, the of personalized help, • Call 1 800, MEDICARE Remember: Keep this Creditable, and Insert - Entities can choose field.

You need to give specific information inside the box above ranges, stated individual The date, been occurred, has that To : To: , covered after, From : From:, creditable under 15, Date: Name of Entity, Sender CMS Form 10182, CC Updated April 1, and According to the Paperwork.

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