A Medicare Summary Notice (MSN) is not a bill, even though it lists what your providers charged and the most they're allowed to bill you. Medicare mails the MSN to people with Original Medicare so they can check the services billed in their name and see what Medicare paid. Learning how to read your Medicare Summary Notice takes a few minutes once you know what each page and column means, and the notice itself points you to the next step when a claim is denied or a charge looks wrong.

In This Guide

What is a Medicare Summary Notice, and is it a bill?

Medicare.gov describes the Medicare Summary Notice (MSN) as a notice, not a bill, that people with Original Medicare get in the mail for their Medicare Part A and Part B-covered services. According to Medicare.gov, each MSN shows the services or supplies that providers and suppliers billed to Medicare during the notice period, what Medicare paid, and the maximum amount you may owe the provider.

The Centers for Medicare & Medicaid Services (CMS) sets out what the notice must contain in its Medicare Claims Processing Manual, Chapter 21. That manual describes the MSN as a printed notification, sent to Medicare beneficiaries enrolled in Original Medicare, that displays data for claims processed during a given reporting period. CMS's manual also says the MSN gives you a record of the services you received and the status of your deductibles, and that it informs you of your appeal rights.

So when an MSN arrives in your mailbox, or in a parent's, it isn't something to pay. It's a record to set beside the bills and receipts from the same months, so you can confirm that the care listed is care you actually got and that nobody is asking for more than the notice allows.

How often do you get a Medicare Summary Notice in 2026?

Medicare.gov says a person with Original Medicare gets a Medicare Summary Notice every 6 months if they get any services or medical supplies during that period. A person with Original Medicare who gets no services or medical supplies during that period won't get an MSN, so a missing notice after a quiet six months is expected.

CMS's own rules set the timing. The Medicare Claims Processing Manual, Chapter 21 (Revision 13380, effective January 1, 2026), states that Medicare Administrative Contractors (MACs) shall issue No-Pay MSNs on a 180-day mailing cycle. The same CMS manual defines No-Pay MSNs as MSNs that do not require payment to the beneficiary for the claims on them, and it says MSNs with a payment check to the beneficiary continue to be mailed out as they're processed.

In practice, that means an MSN that carries a check made out to you can arrive between the usual six-month notices. If your mailing address has changed, Medicare.gov says a person with Original Medicare should contact Social Security to update the address the MSN goes to, or contact the Railroad Retirement Board (RRB) if they get RRB benefits.

How do you read each page of the Medicare Summary Notice?

CMS's Medicare Claims Processing Manual specifies that every Medicare Summary Notice has four sections, and knowing them lets you go straight to the part you need.

  1. Page 1, the summary: A one-page summary of your Medicare status and of the claims on the notice, which Medicare.gov calls your dashboard. On page 1 of the MSN you can check your name, the last 4 numbers of your Medicare number, the date the MSN was printed, and the dates of the claims listed. Page 1 of the MSN also shows your deductible information and a summary of your approved and denied claims, along with the total you may be billed. For reference, the 2026 annual deductible for all Medicare Part B beneficiaries is $283, which you pay once each year before Original Medicare starts to pay.,
  2. Page 2, making the most of your Medicare: One page of tips on how to use your MSN, get help with Medicare issues, and learn more about Medicare services.
  3. Page 3 onward, the claims: A section, which may run over several pages, that lists the claims submitted to Medicare for you during the period of the notice.
  4. The last page, denials and appeals: One page with details on your appeal rights and, more generally, on how to get help with denied claims.

If you can't find the Medicare card to compare against the number on page 1, Brevy's guide on how to replace a Medicare card walks through getting a new one.

How do you read the columns on the MSN claims page?

The claims pages are often the most confusing part of the notice, because several columns carry dollar amounts that look similar. The definitions below come from the Medicare Summary Notice text in CMS's Claims Processing Manual for Part B claims where the provider accepts assignment.

Column on the MSN What CMS says it means
Service Approved? Tells you whether Medicare covered the service. Medicare.gov's sample guide says this column shows whether a claim was approved or denied.
Amount Provider Charged The provider's fee for the service.
Medicare-Approved Amount The amount a provider can be paid for a Medicare service. It may be less than what the provider charged, and the provider has agreed to accept it as full payment for covered services. Medicare usually pays 80% of it.
Amount Medicare Paid The amount Medicare paid your provider, usually 80% of the Medicare-approved amount.
Maximum You May Be Billed The total amount the provider is allowed to bill you. It can include a deductible, coinsurance, and other charges not covered.

CMS's MSN text adds that if you have Medicare Supplement Insurance (a Medigap policy) or other insurance, that coverage may pay all or part of the Maximum You May Be Billed amount.

Medicare.gov's guide to the sample Part B MSN notes that claims can be either assigned or unassigned, and CMS's MSN text explains what changes on an unassigned claim. On an unassigned Medicare Part B claim, the provider hasn't agreed to accept the Medicare-approved amount as payment in full. On a Part B claim, a provider who doesn't accept assignment may charge up to 15% over the Medicare-approved amount, which is known as the limiting charge. When a provider doesn't accept assignment, Medicare pays you directly, usually 80% of the Medicare-approved amount, and the MSN shows that payment as "Medicare Paid You."

Because the Maximum You May Be Billed column is the most a provider is allowed to bill you for that claim, it's the number to hold any provider bill against. If a bill is higher, ask the provider's office to explain the difference before you pay. Brevy's guide to Medicare Part B excess charges explains the limiting charge in more depth, and if you're enrolled in the Qualified Medicare Beneficiary (QMB) program, see our guide to QMB and balance billing.

What should you check when your MSN arrives?

CMS prints a short "How to Check This Notice" list on its sample Part B Medicare Summary Notice, and Medicare.gov adds a few steps of its own.

  1. Check whether you recognize the name of each doctor or provider listed on the MSN.
  2. Check the dates on the MSN and ask yourself whether you had an appointment on each of those days.
  3. Check whether you got the services listed, and compare them against your receipts and bills. Medicare.gov suggests keeping your receipts and bills so you can confirm you got every service, supply, or piece of equipment the MSN lists.
  4. If you already paid a bill before the MSN arrived, compare the MSN with that bill to make sure you paid the right amount, and check the maximum you may be billed.
  5. See whether the claim was sent to your Medicare Supplement Insurance (Medigap) plan or another insurer, because CMS's sample MSN says that plan may pay your share.
  6. If you have other insurance, Medicare.gov says to check whether it covers anything Medicare didn't.

For an adult child helping a parent, this list is a practical way to split the work: the parent often remembers the appointments, and you can line the notice up against the bills.

What if a service was denied on your MSN?

A denial on your Medicare Summary Notice is often worth a phone call before it's worth an appeal. Medicare.gov says that if an item or service is denied, you should call your doctor's or other health care provider's office to make sure they submitted the correct information, and that the office may resubmit if they didn't.

CMS's sample Part B MSN lays out the same path in a little more detail:

  1. Call or write the provider and ask for an itemized statement for the claim.
  2. Make sure the provider sent in the right information.
  3. If the provider didn't send the right information, ask the provider to contact the Medicare claims office to correct the error.

If the provider's information was right and you still disagree with the decision, Medicare.gov says you can file an appeal, and the next section covers how the MSN itself tells you to do that.

How do you appeal from your Medicare Summary Notice?

Medicare.gov states that a person with Original Medicare who disagrees with any decision on their Medicare Summary Notice can file an appeal, and that the last page of the MSN gives step-by-step directions on when and how to file it. CMS's sample Part B MSN states that appeals must be filed in writing.

Pay close attention to the deadline. CMS's sample Part B MSN says the Medicare claims office must receive your appeal within 120 days from the date you get the notice, and Medicare.gov's guide to the sample MSN says the date printed in the box on the notice is the date your appeal must be received. Because that deadline is a receive-by date, mail an MSN appeal early enough that it arrives before the date in the box.

CMS's sample Part B MSN walks through the appeal like this:

  1. Circle the services or claims you disagree with on the notice.
  2. Explain in writing why you disagree with the decision.
  3. Fill in your full name (or your representative's), your telephone number, and your complete Medicare number.
  4. Write your Medicare number on every document you send.
  5. Make copies of the notice and all supporting documents for your records.
  6. Mail the notice and all supporting documents to the claims office address shown on the MSN.

You don't have to do this alone. CMS's sample MSN says you can appoint someone, such as a family member or friend, to be your representative in the appeals process. The same sample MSN says you can call 1-800-MEDICARE or your State Health Insurance Assistance Program (SHIP) for help before you file a written appeal, including help appointing a representative.

Brevy's guide to free SHIP counseling explains what a SHIP counselor does, and our guide to appealing a Medicare denial covers the appeals process beyond the MSN.

What if your MSN lists care you never got?

If your Medicare Summary Notice lists a service you don't recognize, start with the checklist above: confirm the provider's name and whether you had an appointment that day. When a charge still doesn't match anything you or your parent received, treat it seriously.

CMS's sample Part B MSN tells a person who thinks a provider or business is involved in Medicare fraud to call 1-800-MEDICARE (1-800-633-4227). The same CMS sample MSN gives two examples of fraud: offers for free medical services, and billing you for Medicare services you didn't get.

Brevy's guide to protecting yourself from Medicare fraud covers common scams and what to do next.

Can you get your Medicare Summary Notice electronically?

Yes. Medicare.gov states that a person with Original Medicare who chooses electronic Medicare Summary Notices won't get printed copies of their MSNs in the mail, and will instead get an email with a link to their MSN for any month they have a processed claim. A CMS consumer publication, "Cut the Clutter: Go Digital with Medicare," likewise says you'll get an email with a secure link to your electronic MSN every month you have claims.

Medicare.gov lists these steps to sign up for electronic MSNs:

  1. Log into (or create or connect) your Medicare account using ID.me, CLEAR, or Login.gov, and go to "My account settings."
  2. Under "Email and document settings," select "Edit" next to Medicare Summary Notices (MSNs).
  3. Under "How do you want to get your MSNs?", select "Electronically" and then "Save Changes."

Medicare.gov also lists viewing your Original Medicare claims as soon as they're processed among the things you can do in a Medicare account. Medicare.gov says electronic MSNs help prevent fraud by making sure you're billed only for the services you've gotten.,

Frequently Asked Questions

Why did I get an MSN if I have a Medigap plan?

You get a Medicare Summary Notice because you have Original Medicare: Medicare.gov describes the MSN as a notice people with Original Medicare get for their Part A and Part B-covered services. A Medicare Supplement Insurance (Medigap) policy may pay all or part of the Maximum You May Be Billed amount on the MSN, so that column is the figure to hold against what your Medigap plan pays and what the provider still bills you., Brevy's Medigap guide explains how the plans differ.

Do I get an MSN if I'm in a Medicare Advantage Plan?

The Medicare Summary Notice is an Original Medicare notice: CMS's Claims Processing Manual describes the MSN as a notification sent to Medicare beneficiaries enrolled in Original Medicare. If you're in a Medicare Advantage Plan, ask the plan how it reports your claims. Our comparison of Original Medicare and Medicare Advantage explains how the two differ.

Can I get my MSN in large print or Braille?

Yes. Medicare.gov states that Medicare Summary Notices are also available in an accessible format like large print or Braille, if you need it.

Can I help my parent appeal a claim on their MSN?

Yes, as their representative. CMS's sample Medicare Summary Notice says a person can appoint someone, such as a family member or friend, to be their representative in the appeals process. The appeal directions on the sample MSN ask for the full name of the person appealing or their representative, and say to write the Medicare number on every document sent with the appeal.

Learn More

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Find personalized help reading your own or a parent's Medicare Summary Notice at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

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