After enrolling in Medicare, you’ll receive a Medicare Summary Notice (MSN) by mail every three months. This document provides an overview of the health care services and supplies billed to Medicare, as well as what Medicare has paid on your behalf.
What is a Medicare Summary Notice (MSN)?
A Medicare Summary Notice is a statement, not a bill, that details:
- Services and supplies your providers billed to Medicare.
- What Medicare covered and paid.
- Any remaining amounts you may be responsible for.
If you have additional insurance (such as a Medicare Supplement or Medicare Advantage plan), those policies may cover remaining costs, reducing your out-of-pocket expenses.
How to Read Your Medicare Summary Notice
Your MSN includes an easy-to-read summary with:
- Dates of service
- Provider or supplier names
- Amount Medicare paid
- Deductibles, coinsurance, and non-covered charges
- Notes on any adjustments or denied claims
To ensure accuracy, compare the amounts on your MSN with your receipts, bills, and personal records.
Tracking Medicare Claims Online
Instead of waiting for your MSN in the mail, you can check your Medicare claims online:
- Visit MyMedicare.gov.
- Claims are typically available for viewing within 24 hours of processing.
Medicare Advantage and Medicare Supplement Claims
Your claims process depends on your Medicare plan type:
Original Medicare (Parts A & B):
- Your provider submits claims directly to Medicare.
- Medicare pays the provider, and you cover any remaining balance (such as coinsurance or deductibles).
Medicare Supplement (Medigap) Plans:
- Your provider submits claims to Medicare.
- Medicare pays its portion, then your Medigap plan covers eligible remaining costs.
- You receive an Explanation of Benefits (EOB) detailing what has been paid and if you owe anything.
Medicare Advantage (Part C) Plans:
- Instead of Medicare processing claims, your insurance company handles all claims and payments.
- You only need to present your Medicare Advantage plan ID card (not your Medicare card).
What to Do if Your MSN Shows an Adjusted or Denied Claim
If you see a claim adjustment or denied service, take the following steps:
- Contact your provider or supplier – They may need to correct or resubmit the claim.
- Review Medicare’s explanation – Look for notes on why Medicare adjusted or denied the claim.
- File an appeal if necessary – If you believe a claim was unfairly denied, you can appeal through Medicare.
How to File a Medicare Claim Yourself
In most cases, providers handle claim submissions, but you may need to file a claim yourself if:
- The provider refuses or delays submitting a claim.
- The provider is not enrolled in Medicare.
- You received treatment outside the U.S. under certain conditions.
Steps to File a Medicare Claim:
- Complete the Patient’s Request for Medical Payment (CMS-1490S) form.
- Obtain an itemized bill from your provider, listing services, dates, and charges.
- Write a letter explaining why you’re submitting the claim yourself.
- Submit all documents to your Medicare Administrative Contractor (MAC) for your state.
- Medicare typically processes claims within 60 days.
Important: Claims must be filed within 12 months from the date of service.
Protecting Yourself from Medicare Billing Errors
- Keep your receipts and bills – Compare them with your MSN for accuracy.
- Check for duplicate charges or errors – Just like reviewing a credit card statement.
- Verify secondary insurance payments – Ensure your Medigap or other coverage has paid its portion.
If you notice a discrepancy, contact your provider or Medicare immediately.
Need Help Understanding Your Medicare Coverage?
MedicareMall has over two decades of experience helping beneficiaries navigate their Medicare options. Whether you need assistance with claims, finding the best plan, or ensuring you’re not overpaying, we’re here to help.