Plain-English guides to health, Medicare and money after 60

Bonivitas
Medicare

How to Read Your Medicare Summary Notice

Your Medicare Summary Notice is not a bill. It is a record of services billed to Original Medicare. Here is how to read it, spot errors and appeal a decision.

By the Bonivitas editorial team

Updated

2-minute read

Older woman in glasses and a pink blouse reading papers at a desk
Comparing your notice with your own appointment notes can help catch billing errors. Photo: Pexels

Key takeaways

  • The Medicare Summary Notice lists services billed to Original Medicare; it is not a bill.
  • It arrives every four months if you used Medicare-covered services, and you can see claims sooner online.
  • Check for services you did not receive, which can be a sign of fraud.
  • You generally have 120 days from receiving the notice to appeal a decision.

If you have Original Medicare, you will receive a document called the Medicare Summary Notice, or MSN, every few months. It can look like a bill, but it is not. It is a record of the services and supplies your providers billed to Medicare, what Medicare paid and the most you may owe.

Reading it takes a few minutes, and it is one of the best ways to catch billing mistakes and Medicare fraud.

When you get it

Medicare mails a Summary Notice every four months if you received any Medicare-covered services during that period. If you did not use any services, you will not get one.

You can see your claims sooner, often within a day of processing, by logging in to your account at Medicare.gov. You can also choose to receive your notices electronically.

People in Medicare Advantage plans do not get Medicare Summary Notices. Their plans send an Explanation of Benefits instead.

What is on the notice

The first page gives an overview:

  • Your name, address and Medicare number, with only part of the number shown.
  • Whether Medicare approved all your claims during the period.
  • How much of your Part B deductible you have met for the year.
  • The total amount you may be billed.

The following pages list each claim, including:

  • Date of service and provider name.
  • Service description and a billing code.
  • Amount the provider charged.
  • Medicare-approved amount, which is usually lower than the charge.
  • Amount Medicare paid.
  • Maximum you may be billed.

If you have a Medigap policy or other coverage, it may pay some or all of the "maximum you may be billed."

How to check it

Compare the notice with your calendar, receipts or notes from appointments. Ask yourself:

  • Did I actually receive each service on that date?
  • Do I recognize each provider?
  • Was I billed twice for the same service?
  • Does the "maximum you may be billed" match the bill I received from the provider?

Do not pay a provider bill until you have compared it with your Summary Notice.

How to appeal

If Medicare denied a claim and you think the service should be covered:

  1. Circle the item on your notice and write why you disagree, or fill out a Redetermination Request Form.
  2. Include your name, phone number and Medicare number, and any supporting documents, such as a letter from your doctor.
  3. Send it to the Medicare contractor address shown on the notice.

You generally must file within 120 days of receiving the notice. Keep copies of everything you send. Your SHIP counselor can help you with an appeal for free; see how SHIP counseling works.

Keep your notices

Keep your Summary Notices for at least a year, or longer if you itemize medical deductions on your taxes or have an appeal in progress. Shred them when you no longer need them, since they include personal information.

Sources

We checked this guide against these sources. Figures change, so confirm current amounts with the source before you act.

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