Medicare statements outline payments made on a beneficiary’s behalf for Medicare covered services. There are two primary types of statements received by Medicare beneficiaries: Medicare Summary Notices (MSNs) and Explanations of Benefits (EOBs).
Beneficiaries enrolled in Original Medicare receive MSNs.
- Beneficiaries enrolled in Medicare Advantage (Part C) plans receive EOBs.
- Beneficiaries enrolled in Medicare prescription drug (Part D) plans receive EOBs.
MSNs and EOBs explain:
What the health care provider billed for
- The amount approved by Medicare for payment
- How much Medicare paid
- What the beneficiary may be billed for
Detect Potential Fraud, Errors, or Abuse
- Review yours or your loved ones' Medicare statements as soon as they arrive to ensure all of the services listed were actually received.
- Keep a record of medical visits, tests, receipts for services, and equipment received. A Personal Health Care Journal, available from your local SMP, can help you keep a record of these services.
- Compare your statements to your receipts, records, and Personal Health Care Journal. If you notice any mistakes, or have questions, call your provider or plan with your questions. If you still have questions or need further help, contact your local SMP (select your state on the left and click "search").
- Medicare’s www.MyMedicare.gov website allows beneficiaries in Original Medicare to view their most recent MSNs, track claims made on their behalf, and check payment status. Registering for access to Medicare’s free, secure online service allows you to review all bills processed within the past 36 months.
How to Read Your MSN
The Medicare Summary Notice (MSN), which provides information on Original Medicare claims, is one of the key tools that the SMP program uses for catching fraud, errors, and abuse. Reviewing and understanding MSNs is crucial for both Medicare beneficiaries and for SMPs. This 20-minute tutorial reviews the basics of how to read your MSN.
Report Suspected Fraud
To report suspected fraud, click here.