Transparency
Understand your Medicare statement. Before paying a bill.
A Medicare Summary Notice is not a bill. It shows claims for Original Medicare, what Medicare paid, and the maximum you may owe. Here is how to check navigation services, other coverage, and any bill that follows.
Prefer to speak with someone? Call 628 234 2273 (NAV-234-CARE). Bring your questions about the statement. We will answer all of them.
Line by line
The six lines that matter.
This is an explanation of common Part B claim fields, not an actual notice or a personal cost estimate. Check your own service dates, coverage decision, and claim notes.
Medicare Summary Notice · Part B (Medical Insurance) · Sample
- Service description
- The covered navigation service
- PIN and CHI are different covered services. Ask the team which service and billing practitioner or practice to expect, then compare that with the notice.
- Procedure codes
- Codes for the service billed
- The codes depend on the covered service and work billed. Ask the billing office to explain unfamiliar codes and dates; do not infer a fixed monthly price from a code alone.
- Amount charged
- The practice’s billed amount
- This is what the provider submitted, not automatically the amount you owe. Review it alongside the Medicare-approved amount, coverage decision, and notes.
- Medicare-approved amount
- The amount Medicare approves
- For covered PIN or CHI under Original Medicare, the published cost rule is the Part B deductible followed by 20% of the Medicare-approved amount. Use your actual claim, not a generic national price.
- Medicare paid
- The payment shown for this claim
- The amount can be affected by the deductible and coverage decision. Check the claim details rather than assume Medicare paid the same share for every line.
- You may be billed
- The maximum the notice says you may owe
- Other insurance or assistance may cover some of this amount. Check its statement too. Do not assume every secondary plan pays the full amount or that the MSN reflects every later payment.
Illustrative layout for Original Medicare. Formats and claim details vary. Medicare Advantage members should use their plan's documents.
What to do when it arrives.
- 01
Match the services and dates
Compare the notice with your records. Ask about any service, provider, or date you do not recognize.
- 02
Read the coverage decision and notes
Look at the approved amount, Medicare payment, and maximum you may owe together. The billed charge alone does not tell you your responsibility.
- 03
Check other coverage
Medicare advises checking whether other insurance covers amounts it did not pay. Compare the secondary statement and ask about any pending claim.
- 04
Compare a provider bill
Keep bills and receipts, and compare them with the notice and other coverage payments. Ask the billing office to explain a mismatch and clarify any payment due date.
- 05
Act on a denial promptly
Ask the provider whether the claim information is correct. If you disagree with Medicare's decision, follow the appeal instructions and deadline on the last page of your notice.
Questions about the statement
When will I receive a Medicare Summary Notice?
Medicare currently says paper MSNs are sent every six months when you receive services or supplies in that period. If you choose electronic MSNs, you receive an email link for any month with a processed claim. A notice can include multiple service dates; it is not a bill.
The statement shows a practice name I do not recognize. Is that right?
It may be the practitioner or practice billing for the covered service. Ask Navigate Care or the billing office to identify the service and provider before assuming it is correct or incorrect. Compare the dates with care you actually received.
It says “you may be billed” an amount but I have Medigap. Do I pay it?
The MSN itself is not a bill. Check whether your Medigap policy covers the amount and compare its statement with any provider bill. If a bill arrives while a claim is pending or the figures do not match, contact the billing office and insurer to clarify what is due and when.
What if I have a Medicare Advantage plan?
Use your plan's Explanation of Benefits and coverage rules. This page's MSN example is for Original Medicare; plan layouts, covered services, provider participation, and patient costs can differ. Ask the plan and provider to explain the relevant claim.
Can I see a sample statement?
Yes. Medicare publishes sample Part A, Part B, and durable medical equipment notices on its Medicare Summary Notice page, linked below. Use the sample relevant to your service and compare it with your own notice.
Check Medicare's own explanation
Primary sources checked September 2026.
Guides
Read more about this
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How to read a Medicare denial letter
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Ask us about the part that does not make sense.
Tell us what is happening. We will listen, check whether Navigate Care can help and explain the next step.
Or call 628 234 2273 (NAV-234-CARE). Free initial call. No obligation.