Reviewing your quarterly Medicare Summary Notice (MSN) is important, but understanding it can be a challenge.
See also: Understanding your Medicare statement.
That's why AARP has created two easy-to-use MSN "decoders": one for Part A and the other for Part B. The text below is a printable version of what appears within the pop-up boxes of AARP's Part B Medicare Summary Notice Decoder.
1. Medicare Summary Notice: Medicare sends out statements like this example quarterly. If you didn’t use any medical services in a particular three-month period, a statement won’t be sent. Your Medicare Summary Notice shows all services billed to your Medicare Part B account for doctors’ services, tests, outpatient care, home health services, durable medical equipment, preventive services and other medical services.
2. Name and Address: If the name or address listed here is not correct, visit your local Social Security Administration office or call 800-772-1213 (TTY 800-325-0778 for the deaf or hard of hearing), weekdays from 7 a.m. to 7 p.m. You can also make the corrections online at SSA.gov.
3. This is Not a Bill: Yes, that's right! Your Medicare Summary Notice is not a bill. It is a statement you should review for accuracy and keep for your personal records.
Very important: Never send a health care provider payment for charges listed on a Medicare Summary Notice until you've received a bill for the service directly from the provider. If you have already paid the provider, check to make sure that what you paid matches the amounts on your Medicare Summary Notice. If you paid more than needed, contact the provider's billing office to request a refund.
4. Your Medicare Number: This is the number on your Medicare card. Protect it just as you would a credit card, bank account or Social Security number (because, as you may have noticed, it is your Social Security number!).
5. Date Notice Printed: This is the date the notice was mailed. Medicare Summary Notices are sent out four times a year — once a quarter — but you don’t have to wait for your notice to arrive in the mail. You can also check your account online at MyMedicare.gov. Claims typically appear on your electronic statement 24 hours after processing.
6. Did Medicare Approve All Services?: “YES” means that Medicare covers this type of health care service. If you see “NO” in this space, contact your provider and ask for an itemized statement. Go to the section “How to Handle a Denied Claim” (below). For more about noncovered services, see the article "What Medicare Doesn't Cover."
7. Total You May Be Billed: This is the maximum amount your doctor can bill you. It may include your deductible ($140 in 2012), your 20 percent coinsurance charges or any other expenses that Medicare does not cover. Compare your Medicare Summary Notice with the doctor’s billing statement to make sure you are paying the correct amount. Contact your doctor if you spot errors in this section of your MSN.
If you have a Medicare supplemental insurance policy (also called medigap), Medicare will send this claim information to your insurance company. Your supplemental insurance may cover some or all of the costs not paid by Medicare.
8. Your Deductible Status: Each year you must pay a deductible ($140 in 2012) for health services before Medicare begins to pay. This section shows how much of this annual deductible you have paid.