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Mail-in Application for Payment of Medicare Part B Premium (PA 600-M) [PDF]

Authored By: Pennsylvania Department of Human Services

The PA 600M is a mail-in application for payment of the Medicare Part B premium only. It is used to help elderly individuals or individuals with disabilities who are eligible for Medicare to pay some or all of their Medicare Part B premium. A face-to-face interview is not required when using this application. The application cannot be used to apply for Medicaid (Medical Assistance), cash assistance or food stamps.

Last Review and Update: Nov 01, 2004