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What is a Medicare Summary Notice?

With Original Medicare, your healthcare provider bills Medicare directly for any medical care that you get. Medicare then pays your provider directly for that care. And every three months, you’ll get a paper notice in the mail called the Medicare Summary Notice (MSN).

This handy printout isn’t a bill, though it might seem like one. Instead, the MSN is more akin to an Explanation of Benefits, something you might be familiar with if you had major medical insurance before you had Medicare. It’s a statement listing expected charges and what you might owe.

But even if you don’t know what that is, it’s important to know what a Medicare Summary Notice is and what it tells you. It’ll help you keep track of your expenses as well as spot any potential mistakes or fraud.

The Medicare Summary Notice (MSN) is a notice that Medicare sends out every three months to people with Original Medicare (Part A and/or Part B). It outlines:

  • All services and supplies that providers/suppliers billed to Medicare during the three-month period included in the notice;
  • The amount that Medicare paid for these services and supplies; and
  • The max amount that you might owe (i.e., what Medicare didn’t cover).

This is similar to an Explanation of Benefits, which is a statement that private insurance companies send to their customers to alert them about potential medical bills based on recent medical care they’ve gotten.

Will I get a Medicare Summary Notice every month?

Medicare sends out a summary notice every three months, so the most you’ll get in a single year is four, about one every quarter. But that doesn’t mean you’ll always get four in a year. If you don’t have any medical care or services during a three-month period, you won’t get a summary notice for that period. You only get the notice each quarter if Medicare’s been billed on your behalf during that quarter.

Can I get the notice sooner?

Yes, but you have to agree to get your Medicare Summary Notice electronically. Once you create an account with Medicare (here), you can choose an electronic Medicare Summary Notice (eMSN) instead of the paper one. The eMSN gets delivered via email every month instead of every three months.

There are a few advantages to the eMSN vs. the traditional paper statement:

  • You can see your medical expenses closer to real time. Instead of waiting for a quarterly statement, you’ll be able to see your charges each month.
  • You’ll be able to track your deductibles.
  • It may help you catch mistakes, errors or potential fraud sooner.

Getting your statement online can also reduce a buildup of paper waste. Of course, if you prefer a physical copy of your summary notice, you can always stick with the traditional mailed form. But the only way to get a copy sooner is to choose the online option.

What does the Medicare Summary Notice look like?

The Medicare Summary Notice will include a few pages with a set amount of information, including:

  • The dashboard, which is a summary of your notice;
  • Tips on how to review the information in the notice;
  • Your claims information; and
  • A page on how to handle denied claims.

You’ll get a notice for Part A and/or Part B depending on the care you received during the statement period. If applicable, you may also get one for durable medical equipment (DME), which is covered under Part B but has its own summary notice.

If you want to get an idea of what the form actually looks like, Medicare has samples of the Medicare Summary Notice on its website. Here’s the Part A Medicare Summary Notice, for example.

Does everyone get a Medicare Summary Notice?

No, actually. The Medicare Summary Notice is only for people with Original Medicare. That includes Part A and Part B. If you have Medicare Part D (standalone prescription drug coverage) or a Medicare Advantage plan, you won’t get a summary notice. You’ll get an Explanation of Benefits (EOB) instead, and it may come more often than every three months.

For people with these private Medicare options, an EOB works in a similar way. It should list out the medical care, services and/or prescription charges you’ve gotten for the time period on the statement along with an estimate of what you might have to pay out of pocket.

Like the MSN, the EOB is not a bill. And if you have questions or concerns about the charges listed on it or your coverage in general, you should contact your provider or your health insurance company directly.

What’s the point of it?

The Medicare Summary Notice helps you see your medical expenses and what Medicare’s been billed on your behalf. It’s a secondary piece of information to put with your bills and other documents as part of your at-home medical records.

But there’s another purpose for this notice, too.

Medical billing errors are, unfortunately, pretty common. This quarterly statement from Medicare gives you a chance to review your charges and services, compare them to your own statements and experience, and make sure that what Medicare got billed for is correct.

In a perfect world, this would be as simple as glancing at the charges and saying, “Yep, that looks okay.” But this isn’t a perfect world, and you need to read through the MSN carefully for errors.

When you get the MSN, grab your own medical statements and any documentation you have from the last three months (the time period on the statement) and compare it to the form. If you see any discrepancies or anything that doesn’t make sense, follow the form’s instructions for reporting errors or appealing denied claims. It may be a simple issue that your doctor can resolve by updating a claim code, or you may need to file an official appeal with Medicare.

Either way, take the MSN as an opportunity to double-check your charges and make sure you’re not being billed incorrectly. Remember: the form itself is not a bill, but you can use it to get a sense of bills you might be getting (and to confirm or question bills you’ve already gotten).

In other words, the point of the Medicare Summary Notice is to help track medical expenses and in doing so, to prevent or address errors and fraud in the program.