| Thu, Mar 21, 2013 @ 09:00 AM

How to Read Your Medicare Summary Notice

Posted by Medicare Made Clear

medicare summary notice updatesIf you have Original Medicare, you receive a Medicare Summary Notice (MSN) every three months. It lists all of your health care claims for the period. There is an MSN for Part A and a separate one for Part B.

Medicare redesigned the MSN in 2012 to help make it easy to read. You may have already seen the new MSN online at MyMedicare.gov where it is already in use. If not, then you will soon receive a paper version in the mail.

For a quick look, you can see a side-by-side comparison of the old and new Part B MSNs on Medicare’s web site.

Get the Facts Up Front

The first page of your new MSN is an overview. It shows:

  • The time period for the claims reported in the document
  • How much of your deductible you’ve paid
  • The doctors and other providers for the reported claims, with the date you received the service or supply
  • How many claims Medicare denied during the period, if any
  • The total you may be billed by providers

This summary lets you quickly identify anything that you may want to pay special attention to in the rest of the document. For example, you may see a provider name that you don’t recognize. Or maybe you don’t recall receiving a service on the date listed. And, of course, you will want to look more closely at any denied claims.

Remember that your MSN is not a bill. The first page shows an amount that you may be billed, but that doesn’t mean you will owe it. You may not be billed at all. If you are, you may have a Medicare supplement plan or some other insurance that may pay.

Learn About Managing Claims

The second page of your MSN provides important information that can help you manage your health and your Medicare claims. You may see messages about preventive services, coverage limits and how to use your Medicare benefits. In addition, there’s a handy little guide with tips about how to read your MSN.

This page also has directions for how to report possible Medicare fraud.  As it says on the MSN, “You can make a difference!” Medicare is hoping that the redesigned MSN will help you spot possible fraud and that you will report it. This is important because, as a fraud victim, you could be denied coverage for something you really need if it looks on paper as if you’ve already received it. If you need further incentive to read your MSNs carefully, Medicare offers a reward of up to $1000 for a tip that leads to uncovering fraud.

Review Claims in Detail

Next comes the real meat of the MSN. Each service you received during the period is fully explained in simple language. This is followed by whether it was approved or not, what the provider charged, what Medicare paid and what you may be billed. Additional notes about the claim appear at the bottom of the page as needed.

It’s important to read this information carefully as soon as you receive your MSN. Check it against your receipts and bills. Note anything that doesn’t look right to you and follow up on it. Call the provider or Medicare to get your questions answered.

You can appeal denied claims using the form on the last page of the MSN. It gives clear directions and all the necessary contact information for initiating an appeal.

If You Have a Private Medicare Plan

If you have a Medicare Advantage or a prescription drug plan, you receive an Explanation of Benefits (EOB) from your plan. The EOB details your Medicare claims, similar to how the MSN does. Each plan has its own EOB. Call your plan’s customer service number if you need help reading your EOB.

For more information, contact the Medicare helpline 24 hours a day, seven days a week at 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048. If you have questions about Medicare Made Clear, call 1-877-619-5582, TTY 711, 8 a.m. – 8 p.m. local time, seven days a week.

Resources

Medicare Summary Notice: Learn more about the Medicare Summary Notice.

Medicare.gov: Visit the official U.S. government site for Medicare.

Medicare Videos: Watch and learn about the parts of Medicare, how to use your plan and more.

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