Here's the short version. A Medicare Summary Notice (MSN) is not a bill. It is the statement people with Original Medicare get in the mail. It lists every service or supply a provider billed to Medicare, what Medicare paid, and the most the provider can bill you. You get one at least twice a year, and only for periods when you had a claim. To read it, check three things: is each provider and date real, is the "Service Approved?" column a Yes, and does the "Maximum You May Be Billed" amount match any bill you got. If something is wrong, call the provider first. If Medicare denied a service and you disagree, you can appeal. Medicare must get your appeal within 120 days of the date you get the notice.
What a Medicare Summary Notice is
If you have Original Medicare (Part A and Part B), Medicare sends you an MSN for your Part A and Part B services. It shows all the services or supplies that providers and suppliers billed to Medicare during that period, what Medicare paid, and the maximum amount you may owe the provider. The words "THIS IS NOT A BILL" are printed on the front. You do not pay anything from the MSN itself. Any bill comes separately from the doctor or supplier.
If you are in a Medicare Advantage plan or a Part D drug plan, you do not get an MSN. Your plan mails you an Explanation of Benefits (EOB) instead, for each month you fill a prescription, see a provider, or file a claim. Our How Do I… guide walks through reading an EOB.
When it comes, and how to get it faster
You get your MSN every 6 months if you got any services or medical supplies during that period. If you had no services, you get no MSN. You can also choose electronic MSNs. Then you get an email with a link to your MSN for any month you have a processed claim, instead of waiting for paper. To sign up, log in to your secure Medicare account, go to "My account settings," and change how you want to get your MSNs to "Electronically." Large print and Braille versions are available if you need them.
You do not have to wait for the notice at all. With a secure Medicare.gov account you can usually see a claim within 24 hours after Medicare processes it. That is the fastest way to catch a problem.
How to read the MSN, page by page
Medicare's sample Part B notice has a set layout. Here is what each part tells you.
- Page 1: your dashboard. This is the summary. It shows your Medicare Number, the date of the notice, and the dates of the claims processed. It answers "Did Medicare Approve All Services?" with a Yes or No, and shows how many services were denied. It also shows the total you may be billed and how much of your Part B deductible you have met so far this year.
- Page 2: how to check the notice. Medicare's own checklist. Do you recognize each doctor or provider? Did you have an appointment on that date? Did you get the services listed? If you already paid, did you pay the right amount? This page also has the fraud phone number and messages from Medicare.
- Page 3 and on: your claims. Each visit is listed with the provider's name and address, the date of service, and one line per service. Each line has the columns explained below. Any denied service shows NO in the "Service Approved?" column.
- Last page: denied claims and appeals. Step-by-step directions on how to appeal, the address to send it to, and the date your appeal must be received.
What the columns mean
The claims pages use the same columns for every service. Medicare defines them this way:
- Service Approved? Whether Medicare covered this service. Yes or NO.
- Amount Provider Charged. Your provider's fee for the service. This is not what you owe.
- Medicare-Approved Amount. The amount a provider can be paid for a Medicare service. It may be less than what the provider charged. If your provider accepts assignment, they agreed to take this amount as full payment.
- Amount Medicare Paid. What Medicare paid your provider. This is usually 80% of the Medicare-approved amount.
- Maximum You May Be Billed. The total the provider is allowed to bill you. It can include your deductible, coinsurance, and charges Medicare did not cover. If you have a Medigap policy or other insurance, it may pay all or part of this amount.
- See Notes Below. Letters that point to short notes under the claim. A note might say a service was denied and why, or that the claim was sent on to your Medigap plan.
Illustrative example, taken from Medicare's own sample notice (not real charges):
| Column | Sample amount | What it means |
|---|---|---|
| Amount Provider Charged | $143.00 | The doctor's fee |
| Medicare-Approved Amount | $107.97 | What Medicare allows for that service |
| Amount Medicare Paid | $86.38 | 80% of the approved amount |
| Maximum You May Be Billed | $21.59 | Your 20% share |
Notice that the provider's charge does not matter to you when the provider accepts assignment. Your share comes from the approved amount, not the charge. Our costs guide explains deductibles and coinsurance in plain terms.
How to spot billing errors and fraud
Medicare asks you to keep your receipts and bills and compare them to your MSN. Make sure you got every service, supply, or piece of equipment listed. Go line by line and ask:
- Do I know this provider? A name you do not recognize is the first warning sign.
- Was I there that day? Compare the dates and services on your calendar with the statement.
- Did I get this exact service? Watch for things listed twice, tests you never had, or equipment that never arrived.
- If I already paid, did I pay the right amount? Compare the bill to the "Maximum You May Be Billed" figure.
- Did my other insurance pay? If you have other coverage, check whether it covers anything Medicare did not.
For a single odd charge, call the provider's office first. Billing mistakes are common, and the office can fix them. Ask for an itemized statement if the charge is unclear. If a service is denied, call the provider to make sure they sent Medicare the right information. If not, they can resubmit the claim.
If you were billed for services you did not get, or a stranger is billing under your name, that may be fraud. Call 1-800-MEDICARE (1-800-633-4227). Our Medicare scams guide covers the schemes to watch for and every place to report them.
If Medicare denied a service: how to appeal
You have the right to appeal any coverage or payment decision on the notice. Your MSN is where a first-level Original Medicare appeal starts. It is called a redetermination. Appeals must be in writing, and Medicare's claims office must receive yours within 120 days from the date you get the notice. The exact date is printed in the box on the last page.
- Circle the service or claim you disagree with on a copy of your MSN.
- Explain in writing why you disagree. Write on the notice, or attach a separate page.
- Add your name, phone number, and Medicare Number. Include anything that helps, like a note from your doctor.
- Mail it to the Medicare claims office address on the last page of your MSN. You can use the Redetermination Request Form instead if you prefer.
You will generally get a decision within 60 days after the claims contractor gets your appeal. If Medicare agrees to cover the service, it will show up on your next MSN. If not, you get a written decision letter and can move to the next level. If you miss the deadline for a good reason, like illness, you may still be able to file. Free help is available from 1-800-MEDICARE or your State Health Insurance Assistance Program (SHIP), including help naming someone to represent you. Our Your Rights page and the How Do I… guide cover appeals in more detail.
Common questions
Do I have to pay the amount on my Medicare Summary Notice?
No. The MSN is not a bill. It shows the most a provider is allowed to bill you. Pay only when you get an actual bill from the provider, and check that the bill does not go over the "Maximum You May Be Billed" amount on your notice.
Why haven't I gotten a Medicare Summary Notice?
MSNs go out every 6 months, and only for periods when you got services or supplies. If you had no claims, you get no notice. If you signed up for electronic MSNs, look for an email instead of paper. If you have a Medicare Advantage plan, you get an Explanation of Benefits from the plan instead. If your address changed, contact Social Security so notices reach you.
How long do I have to appeal a denied claim on my MSN?
Medicare's claims office must receive your written appeal within 120 days from the date you get the notice. The exact deadline is printed on the last page of the MSN.
What's the difference between an MSN and an EOB?
An MSN comes from Medicare and covers Original Medicare Part A and Part B claims. An Explanation of Benefits (EOB) comes from a private Medicare Advantage or Part D plan and covers that plan's claims. They serve the same purpose: showing what was billed, what was paid, and what you may owe.
Can someone else review my MSN for me?
Yes. You can appoint a family member or friend as your representative in the appeals process. With your Medicare account, you can also download your claims and share them with someone you trust. See our caregivers guide for how authorized representatives work.
Related pages
- How Do I… — step-by-step guides, including how to read a plan's Explanation of Benefits and how to appeal.
- Medicare Scams: How to Spot and Report Them — the schemes circulating now and where to report them.
- Your Rights — appeal rights, surprise-bill protections, and how to file a complaint.
- Understanding Your Costs — deductibles, coinsurance, and assignment explained.
- Claims & Coding — for professionals: how a claim moves from the provider to the payer.
Official sources: Medicare.gov: Medicare Summary Notice, CMS: Sample Part B Medicare Summary Notice (PDF), Medicare.gov: Appeals in Original Medicare, Medicare.gov: Checking the status of a claim, and Medicare.gov: Go digital.