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Ervice is before expiry date by placing an X in the box provided. 3. A Card with VISITOR RHCA indicates Medicare will only pay benefits for IMMEDIATELY NECESSARY MEDICAL CARE. 4. When completing the voucher use the following steps: (a) Imprint the Medicare Card (b) Remove this cover sheet (c) Complete the relevant sections of the forms making sure information entered into a box is completely within the box. EXAMPLE OR OR TIO CTI RA RP THE O 1 2 3 4 5 1 2 / 0 2 / 0 6 X 5. If the service i.

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