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MMA 2003

Medicare Summary Notice

How to Read Your Medicare Summary Notice (MSN) - Part A

Below is a sample Medicare Summary Notice (MSN) for Part A services and information on how to read it. The MSN is not a bill. Do not send money to Medicare or to the provider until you get a bill.

Part A MSN Top

  1. Date: Date MSN was sent.

  2. Customer Service Information: Who to contact with questions about the MSN. Provide your Medicare number (3), the date of the MSN (1), and the date of the service you have a question about (7).

  3. Medicare Number: The number on your Medicare card.

  4. Name and Address: If incorrect, contact the company listed in (2), and the Social Security Administration immediately.

  5. Be Informed: Messages about ways to protect yourself and Medicare from fraud and abuse.

  6. Part A Hospital Insurance - Inpatient Claims: Type of service. See the back of MSN for additional information. (Please Note: For outpatient services, this section is called "Part B Medical Insurance - Outpatient Facility Claims.")

  7. Dates of Service: Dates service was provided. You may use these dates to compare with the dates shown on your hospital bill.

  8. Claim Number: Number that identifies this specific claim.

  9. Benefit Days Used: Shows the number of days used in the benefit period. See the back of your MSN for an explanation of benefit periods. (Please Note: For outpatient services, this column is called "Amount Charged."

  10. Non-Covered Charges: Shows the charges for services denied or excluded by the Medicare program for which you may be billed.

  11. Deductible and Coinsurance: The amount applied to your deductible and coinsurance.

  12. You May Be Billed: The total amount the provider may bill you, including deductibles, coinsurance, and non-covered charges. Medicare supplement (Medigap) policies may pay all or part of this amount.

  13. See Notes Section: If letter appears, refer to (15) for explanation.

  14. Provider's Name and Address: Facility's name and billing address. The referring doctor's name will also be shown. The address shown is the billing address, which may be different from where you receive the service(s).

  15. Part A MSN Bottom
  16. Notes Section: Explains letters in (13) for more detailed information about your claim.

  17. Deductible Information: How much of your deductible you have met for the benefit period.

  18. General Information: Important Medicare news and information.

  19. Appeals Information: How and when to request an appeal.

Note: Medicare & You provides more information about coverage and other services. For a free copy, call the Medicare contractor listed in the Customer Service box on your MSN.

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