Medicare Summary Notice Explained

Who gets this notice

People with Original Medicare get this notice.

It covers Medicare Part A and Part B services.

Medicare sends it. If you are not sure it is from Medicare, Medicare.gov says to look for the signs it lists on the notice envelope.

When it comes

You get the notice every 6 months.

You get it only if you got services or medical supplies in that time.

If you got no services or supplies in that time, you will not get a notice.

Medicare.gov also says people get it in the mail at least twice a year.

What the notice shows

• The services or supplies. These are the ones providers and suppliers billed to Medicare during that period.
• What Medicare paid.
• The maximum amount you may owe the provider. That is the most you may owe. It is not a bill by itself.

It is not a bill

Medicare.gov says this plainly: it is not a bill.

Do not treat the notice itself as a request to pay.

If you already paid a bill before the notice came, compare the notice with the bill. Check that you paid the right amount for your services.

What to do when it arrives

• Keep your receipts and bills. Compare them to the notice.
• Check the list. Make sure you got all the services, supplies, or equipment listed.
• Check other insurance. If you have other insurance, see if it covers anything Medicare did not.

If a service was denied

Call your doctor’s office. Or call the other health care provider’s office.

Ask if they sent the correct information. If they did not, the office may send it again.

If you disagree with a decision, you can file an appeal.

The last page of the notice gives step-by-step directions. It tells you when to file an appeal. It also tells you how to file one.

Ways to get the notice that are easier to read

You can choose electronic notices instead of paper.

With electronic notices, you get an email with a link to your notice. You get it for any month you have a processed claim.

You do not have to wait for a paper copy in the mail.

You can also get the notice in an accessible format. Medicare.gov names large print and Braille as examples.

If your address changes

Contact Social Security to change your address.

If you get Railroad Retirement Board benefits, contact the Railroad Retirement Board instead.

See a sample first

Medicare.gov offers sample notices you can look at.

There is a sample for Part A. There is a sample for Part B. There is also a sample for durable medical equipment.