Medicare - Original
Original Medicare (Paper card with red/blue strip)
HCCC does not have any counselors in network with Original Medicare. However, you can send Medicare a request for medical payment. By submitting Form 1490s and a receipt provided by HCCC, you may be eligible for out of network benefits from Medicare and receive significant reimbursement for your sessions.
HOW TO SUBMIT FORM 1490s
* Select a fully licenced counselor from HCCC
* Pay the self-pay rate of $185
* Ask our team for your reciept (Or request we email you the form)
* Print the Form 1490s from the link below
* Fill out page 1, 2 and 3 of the form.
* Select box?????
* Mail to address listed on the form
* You may be eligible for out of network benefits from Medicare and receive some reimbursement for your sessions.
TIP: Most clients send receipts every few months... not every time they are seen
⤓ Download Form 1490s (English)
