Frequently Asked Questions
What is a Medicare Summary Notice?
A Medicare Summary Notice (MSN) is a statement mailed by Medicare every 3 months listing all services billed to Medicare on your behalf during that period. It shows what Medicare was charged, what Medicare approved, what Medicare paid, and what you may owe. Reviewing your MSN is the most important way to catch billing errors and Medicare fraud.
How often does Medicare send Summary Notices?
Original Medicare mails MSNs every 3 months if you received Medicare-covered services during that period. If you prefer to receive them electronically (faster and more frequent), sign up at MyMedicare.gov where statements are available within 24 hours of claim processing.
What do I do if my Medicare Summary Notice shows a service I didn't receive?
Do not pay it. Contact Medicare immediately at 1-800-MEDICARE (1-800-633-4227). If you see charges for services, equipment, or supplies you never received, this may be Medicare fraud. You can also contact the HHS Office of Inspector General fraud hotline at 1-800-HHS-TIPS.
Is the Medicare Summary Notice the same as a bill?
No — the MSN is not a bill. It is a record of what was billed to Medicare and what Medicare paid. If you owe a remaining amount, you will receive a separate bill from your provider or from Medicare. The MSN shows your estimated portion but is not itself a payment request.
Your Medicare Summary Notice arrives quarterly and most people file it without reading it — a mistake that allows billing errors and fraud to go undetected. Studies show Medicare billing errors affect millions of beneficiaries annually, costing the program billions. Reviewing your MSN takes 10 minutes and can catch errors that save you hundreds of dollars.
The 5 Sections of Your MSN
Section 1 — Claim Summary
Shows the date of service, the provider name, and the type of service. Check each line: did you actually see this provider on this date? If you see a provider you don't recognize or a date when you were not receiving care, flag it immediately.
Section 2 — What Was Billed
The amount your provider charged Medicare. This is the provider's full charge — it is almost always higher than what Medicare actually pays. Do not be alarmed by this number.
Section 3 — Medicare Approved Amount
The amount Medicare considers reasonable for the service. This is usually significantly less than what was billed. Medicare only pays based on its approved amount.
Section 4 — What Medicare Paid
Generally 80% of the approved amount after your deductible. This is what Medicare actually paid the provider directly.
Section 5 — Maximum You May Be Billed
Generally 20% of the approved amount — your coinsurance. If you have Medigap, your supplement should cover this amount. If you received a bill from your provider that is higher than this amount for a Medicare-covered service, it may be a billing error.
Red Flags to Look For
- Services on dates when you were not receiving care
- Duplicate charges for the same service on the same date
- Equipment or supplies you never ordered or received
- A provider name you don't recognize
- Services billed at a different location than where you were seen
- Charges for services your doctor did not recommend or perform
What to Do If Something Looks Wrong
First, call your provider — many errors are honest billing mistakes that can be corrected with a phone call. If the provider cannot explain the charge or you suspect fraud, call 1-800-MEDICARE. Keep all your MSNs for at least one year — they are your record if a dispute arises. For Medicare Advantage, you receive an Explanation of Benefits (EOB) instead of an MSN — the same review principles apply.
→ How to Appeal a Medicare Claim Denial
→ Medicare Fraud: How to Spot and Report It