Medicare Summary Notice Explained in Plain Words
A Medicare Summary Notice, or MSN, is a summary of claims for people with Original Medicare. It lists services or supplies billed to Medicare, what Medicare paid and the maximum amount you may owe. It is not a bill.
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The MSN is for Original Medicare Part A and Part B claims. It is not the same as a statement from a Medicare Advantage plan or a drug plan. Those plans have their own notices and contact rules.
Medicare says paper MSNs generally arrive every six months when you had covered services or supplies during that period. You may not receive one for a period with no claims. Electronic notices may arrive after a claim is processed if you choose that option.
What the main columns mean
The notice groups information by claim. You will usually see the provider, service dates and a description of the service or supply. The money columns show how Medicare handled the claim.
- Amount charged: what the provider or supplier billed.
- Medicare approved: the amount Medicare approved for the listed item or service.
- Medicare paid: the amount Medicare paid to the provider or, in some cases, to you.
- You may be billed: the maximum amount the provider may charge you for that claim.
Check the services before the totals
Compare each line with your appointments, receipts and provider bills. Make sure you received the listed service or equipment and that the date and provider look right. A code or abbreviation may need an explanation from the provider's office.
If you already paid, check whether the payment appears in your records and on the provider's bill. If you have other coverage, ask that plan whether it covers something Medicare did not. Keep the MSN with the matching bills so you can review them together.
What a denial on an MSN means
A “no” or denial message means Medicare did not approve payment for that item as submitted. Read the note beside the claim and the general messages on the notice. The provider's office may need to correct or resubmit information.
If you disagree with the decision, the last page of the MSN gives appeal directions. Original Medicare's first appeal level is called a redetermination. Follow the deadline and mailing instructions printed on your own notice, and include the information requested.
Know which number to call
For a question about a listed service, start with the doctor, provider or supplier. For a question about Medicare's decision, use the contact information on the MSN or your secure Medicare account. The official Medicare website also explains appeal steps.
Keep notes of every call, including the date and reference number. If you send an appeal, keep a copy of the notice and all attachments. Do not assume that calling about a problem replaces a written appeal when the notice requires one.
Official sources
Common questions
Is a Medicare Summary Notice a bill?
No. It explains how Medicare processed claims. A provider or supplier may send a separate bill. Compare that bill with the MSN before paying so the services and amounts can be checked together.
Is an MSN the same as a Medicare Advantage statement?
No. An MSN is for Original Medicare claims. A Medicare Advantage plan may send its own Explanation of Benefits with different rules and appeal instructions. Use the contact information for the coverage you actually have.
Where is the MSN appeal deadline?
Look at the appeal section, usually on the last page of the notice. Follow the date and instructions printed there. If you cannot find them, contact Medicare using the official details on the notice or Medicare.gov.
Have a letter of your own?
Take a photo or upload the pages. LetterWise can explain the words, dates, amounts and next steps in English or Spanish.