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MMA 2003

Medicare Summary Notice

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

Below is a sample Medicare Summary Notice (MSN) for Part B 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 B 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 B Medical Insurance - Assigned Claims: Type of service. See the back of MSN for information about assignment. (Please Note: For unassigned services, this section is called "Part B Medical Insurance - Unassigned Claims.")

  7. Dates of Service: Date service or supply was received. You may use these dates to compare with the dates shown on the bill you receive from your doctor.

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

  9. Services Provided: Brief description of the service or supply received.

  10. Amount Charged: Amount the provider billed Medicare.

  11. Medicare Approved: Amount Medicare approves for this service or supply.

  12. Medicare Paid Provider: Amount Medicare paid to the provider. (Please Note: For unassigned services, this column is called "Medicare Paid You.")

  13. 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.

  14. See Notes Section: If letter appears, refer to (16) for explanation.

  15. Provider's Name and Address: Doctor (may show clinic, group, and/or referring doctor) or provider's name and billing address. The referring doctor's name may also be shown if the service was ordered or referred by another doctor. The address shown is the billing address, which may be different from where you received the services.



  16. Part B MSN Bottom


  17. Notes Section: Explains letters in (14) for more detailed information about your claim.

  18. Deductible Information: How much of your yearly deductible you have met.

  19. General Information: Important Medicare news and information.

  20. 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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