Why Did I Receive a Medicare Summary Notice (MSN)?

If you have original Medicare, you might have received a statement in the mail after you used any services covered by Medicare Part A or Part B. What you received isn’t a bill. It’s a Medicare summary notice (MSN).

The summary notice is a review of any services you get after you use Medicare Part A, Part B, or both. If you have Medicare Advantage, you will not receive summary notices.

Below, we break down what you should know about Medicare summary notices and how they differ from other kinds of communication you may get from your Medicare plans.

What is a Medicare summary notice used for?

Nearly 39 million Americans are enrolled in original Medicare. If you’re one of them, you should receive Medicare summary notices showing everything that your healthcare providers or medical equipment suppliers billed to Medicare, the amount Medicare paid, and any outstanding balance you might owe.

You can use your Medicare summary notices to:

• Prevent fraud and abuse. Make sure that you received every item or service that appears on your claims, whether it’s for medical equipment or a doctor’s visit.

• Confirm that charges are correct. Compare your MSN to your receipts, statements, and bills from healthcare providers, to make sure you were charged the correct amount.

• Track out-of-pocket expenses that go to your Medicare supplement (Medigap) insurance, if you have it.

• Document medical expenses on your taxes. If you claim a medical deduction, MSNs support your tax return.

The summary notice also shows you:

• Your Medicare number

• Date the notice was issued

• When the claims were processed (a 3-month range)

• How close you are to meeting your Part A or Part B deductibles, or if you have met them

• Your remaining covered days in a benefit period if you stayed in a hospital, skilled nursing facility (SNF), or both

• A description of the service or item provided, with date of service and medical billing code

• The amount Medicare paid your provider

• The maximum that you may be billed

• If Medicare sent your claim to Medigap or a different secondary insurance carrier (this may appear in the notes section)

• Which services Medicare denied, if any

• How to file an appeal

When should you get a Medicare summary notice?

Typically, Medicare mails summary notices every 3 months. However, if you don’t use any original Medicare services during a particular quarter, you won’t receive a summary notice.

What’s the difference between a Medicare summary notice and an explanation of benefits (EOB)?

A Medicare summary notice shows the services and items that a person with original Medicare received in a 3-month period.

People with Medicare Advantage or a Part D prescription drug plan get an explanation of benefits when they receive care or fill a prescription. Private insurers mail EOBs once a month if you use services. The explanation of benefits summarizes claims and costs. Each company’s EOB may look different. Like an MSN, an EOB is not a bill.

Can you see a Medicare summary notice online?

Yes. There is an option to view your Medicare summary notices electronically. You can sign up for electronic Medicare summary notices through your MyMedicare account. With this option, you will receive them through email monthly — more quickly than the standard mail option.

If you’re trying to reduce your use of paper, receiving electronic MSNs might be for you, because you can choose when and if you want to print them out. With electronic summary notices, you can still keep track of claims, deductible amounts, catch any errors, and help prevent fraud. Also, if something happens to a paper copy, it’s still accessible through your MyMedicare account.

How long should you keep your Medicare summary notices?

It depends. If you haven’t signed up for a Medicare account, it might be good to hold onto your summary notices for a while in case there are any errors that you may need to correct or appeal. At the very least, consider keeping them to match them with your healthcare bills. It’s also good to wait until the claims are completely processed or until the current 3-month period is over.

However, there might be instances where you’d want to keep them longer, such as claiming medical deductions on your taxes. The IRS recommends keeping records for at least 3 years for tax purposes.

If you have a MyMedicare account, you can see your processed claims from the past 3 years.

When you determine you don’t need your summary notices anymore, don’t just recycle them or throw them in the trash. It’s best to shred them to prevent medical identity theft. This can happen if criminals find intact medical information in your garbage. Medicare identity theft can be difficult and costly to undo.

What should you do if you spot an error in one of your Medicare summary notices?

If you spot an error in your Medicare summary notice, you can start by contacting your healthcare provider to see if they made a mistake on their end. If they did, they can resubmit the claim. You can follow up with Medicare or check your next MSN to make sure the change went through.

However, if it’s a coverage issue that isn’t resolving, you can file an appeal using your summary notice.

How does the Medicare appeals process work?

There are a number of different ways to file an appeal. Your MSN comes with instructions for filing an appeal should you find an error or if a claim was denied. The instructions are generally on the last page of your summary notice. They will tell you to:

• Circle what you disagree with, whether items or claims

• Explain why you disagree

• Fill out your information, including your phone number and Medicare number

• Make a copy of your documents

• Mail them to the address that’s listed

If you run out of room for your explanation, you can attach another sheet of paper to the summary notice. Just be sure to write your Medicare number on all documents.

You have 120 days from the day that you receive your summary notice to file an appeal. If you miss any deadlines in your appeal process, you can file a good-cause extension. Medicare considers extensions case by case. Some examples for a good-cause extension include:

• Your summary notice was mailed to the wrong address

• You received wrong information about your claim

• You or a family member became sick

• You’re helping someone who can’t read or understand the summary notice

There are five levels in the appeals process. If your claim reaches the highest appeal levels — levels three to five — some experts suggest using a lawyer or your healthcare provider to help appeal. If Medicare accepts your appeal at any step in the process, Medicare will cover your claim.

At any point, you may ask for a fast decision if you believe waiting will harm your health. Also, if you believe your covered care is coming to an end soon, and you don’t believe it should, you have the right to a fast appeal.

Who can you contact with questions about your Medicare summary notice?

If you have questions or need a free language translation, there is a help section on your Medicare summary notice. It’s generally on the second page. You may call Medicare at 1-800-633-4227, or 1-877-486-2048 for the hearing impaired. If you need a language translation, say “Agent” when you call. If you have a disability, you can request an accessible format of your MSN.

You may also contact your local State Health Insurance Program (SHIP). SHIP provides free counseling for Medicare enrollees, their families, and caregivers.

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Written by:

Leah Thomason

Leah Thomason was an editorial intern on the GoodRx Health team. She is a writer from Houston, Texas, with an interest in pet health.

Edited by:

Kristen Gerencher, MSOT

Kristen Gerencher, MSOT, is an award-winning writer who's reported on healthcare, medicine, and insurance for various national outlets. Before contributing to GoodRx, she was a healthcare and personal finance reporter for MarketWatch.

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