Skip Navigation
You are here: Home>Medicare Basics>Understanding Claims

Understanding Claims

Medicare Summary Notice (MSN)

A Medicare Summary Notice (MSN) shows all the services or supplies that were billed to Medicare during each 3-month period, what Medicare paid, and what you may owe the provider.

How to File a Claim

If you're in Original Medicare, doctors and suppliers are required by law to file Medicare claims for covered services and supplies you get. In very rare cases, you may need to file a claim on your own. If you get your Medicare healthcare through a Medicare Advantage Plan, these plans don’t have to file claims because Medicare pays these private insurance companies a set amount every month.

Check Your MSNs for Adjusted Claims

Check your Medicare Summary Notices for any changes to your claims. Your provider will let you know what to do next. They may send you a bill for any extra amounts you owe, or they may credit your account or send you a check for any refunds you're due. If you have questions, contact your provider or 1-800-MEDICARE.

Medicare Appeals & Grievances

You have the right to appeal any decision about your Medicare services. This is true whether you're in Original Medicare, a Medicare Advantage plan, or a Medicare Prescription Drug Plan. If Medicare doesn't pay for an item or service you got, or if you aren't given an item or service you think you should get, you can appeal.

47