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Can you submit form CMS-1763 online? No. You have to submit Form CMS-1763 by mail or fax.
CMS is the federal agency that provides health coverage to more than 160 million through Medicare, Medicaid, the Childrens Health Insurance Program, and the Health Insurance Marketplace.
CMS 1763. Form Title. Request for Termination of Premium Hospital Insurance of Supplementary Medical Insurance.
The completion of this form is needed to document your voluntary request for termination of Medicare coverage as permitted under the Code of Federal Regulations.
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