Dear Marci,
I just became eligible for Original Medicare in January. I recently received a letter in the mail from Medicare called a “Medicare Summary Notice.” Is this a bill?
—Sandra
Dear Sandra,
No, a Medicare Summary Notice (MSN) is not a bill. It is a summary of all of the health care services you have received in the past three months. MSNs are usually mailed to you four times a year. They list information about charges submitted to Medicare for health care services, the amount that Medicare paid and the amount you may be billed for by your provider. MSNs will also indicate if a service has been denied and what steps you should take to appeal the denial. You can view your MSNs online at www.mymedicare.gov, but you will still receive paper copies in the mail.
It is important to read your MSNs carefully to learn what Medicare will cover and what you may owe your provider. The first page of the MSN lists general information about your Medicare coverage, and the second page lists tips for reading the notice. The column on the third page called “Maximum you may be billed” is the remaining amount that your provider may bill you after Medicare has paid its share. Since the MSN is not a bill, you will receive separate bills for your provider for any costs that you owe. Check your bills against your MSNs to ensure that you are paying the proper amounts for health care services.
If you have a Medicare Advantage plan, you will receive an Explanation of Benefits (EOB) notice from your plan each month. An EOB is similar to an MSN, in that it is a summary of health care services you have received and how much you may owe your provider. Each plan has their own EOB format, but certain information must be included in every EOB, such as how much you may owe your provider and how much you have paid towards your out of pocket limit for that year. Additionally, you will receive EOBs from your Part D plan that list the prescription drugs you have used in the past month.
—Marci
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Dear Marci,
I turn 65 in a few months, and I want to get Medicare right away. Will I automatically receive my Medicare card in the mail?
—Rose
Dear Rose,
This depends on whether you are already receiving your Social Security benefits. If you are already receiving your Social Security benefits before you are eligible for Medicare, then you will be automatically enrolled into Medicare Parts A and B once you turn 65. You will receive a package in the mail three months before your 65th birthday with your new Medicare card and information about the program.
If you are not collecting Social Security benefits, then you will not be automatically enrolled into Medicare. You will not be mailed a Medicare card automatically, and you will have to actively enroll in Medicare by contacting the Social Security Administration. It is very important that you actively enroll in Medicare during your Initial Enrollment Period, which is the three months before, the month of, and the three months following your 65th birthday.
People turning 65 may think that Medicare will send them a card automatically, but it is important to understand that this does not happen for everyone. Being proactive about your Medicare coverage when you are turning 65 will protect you from gaps in coverage and late enrollment penalties.
—Marci
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Dear Marci,
I currently have a Medicare Advantage plan, but I am interested in purchasing a Medigap policy as well. A friend told me that I cannot have both of these plans. Can I have a Medicare Advantage plan and a Medigap?
—Lawrence
Dear Lawrence,
No, you cannot sign up for a Medigap plan if you have a Medicare Advantage plan. You can only have a Medigap plan if you have Original Medicare, the traditional Medicare program administered directly by the federal government.
A Medigap plan is a health insurance plan that works with Original Medicare to cover some health care costs that Original Medicare does not cover. There are federal guidelines around purchasing Medigap policies, but each state may have additional protections as well. For information on the different types of Medigap plans in your area, you can contact your local State Department of Insurance or State Health Insurance Assistance Program (SHIP).
—Marci
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Marci’s Medicare Answers is a service of the Medicare Rights Center (www.medicarerights.org), the nation’s largest independent source of information and assistance for people with Medicare.
