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I’m New to Medicare, Why do I Get so Many Notices?

If you have reached your “Golden Years,” welcome to Medicare and all of the notices that come with it.  But what do they all mean?

There are several types of notices you will receive, here are just a few.

If you have Original Medicare:

Medicare Summary Notice (MSN) – First, don’t panic –these are not bills. If you have Original Medicare you will receive these every three months (quarterly) for Part A (hospital, nursing home, hospice, skilled nursing & home health)  and Part B (lab, doctor visit, surgeries & supplies) covered services.  The MSN will show all of the services and medical supplies you received in the last 3 months, the approved amount, the amount Medicare paid and the amount you may be billed. If you have not seen a provider or received any medical supplies during the 3 month period you will not receive an MSN this quarter.

You can choose to receive your MSN’s electronically (eMSNs). If you choose this option, you will receive the notices monthly instead of quarterly.  To enroll for this option go to mymedicare.gov, create an account (or sign into your account if you have already done this), go to “My Account” from menu, in the User Information Tab select the “Email and Correspondence” setting,  select “Edit”, click “Yes”, then click "Submit" and you're done.

If you have a part D prescription plan, you will also receive an Explanation of Benefits (EOB) each month. The EOB will list all prescriptions filled the prior month and the total cost for the drug along with your cost. As you know in 2016 the first $3,310 worth of prescriptions are covered by a co-pay. After you reach $3,310 in prescription cost you are in the coverage gap until your out of pocket cost reach $4,850.

If you have a Medicare Supplement Insurance (often called a Medigap plan):

A Medicare Supplement plan is private insurance that supplements Medicare and helps pay the 20% of health care cost that original Medicare doesn’t cover.  Medicare Supplement Insurance helps pay the copays, coinsurance and deductibles that original Medicare doesn’t cover.

You will also receive an Explanation of Benefits (EOB) from the Medicare Supplement carrier showing what was billed by the provider, what Medicare paid, what your carrier paid and what you owe, if anything.

If you have a Medicare Advantage plan (such as Security Blue, Freedom Blue, and UPMC for Life - just to name a few):

You will receive an Explanation of Benefits (EOB) for every claim.  The EOB will tell you how much was charged for the procedure, what amount the carrier paid and how much the provider can bill you. The EOB will also tell you the date of service and who provided the service.

You will also receive a monthly summary showing all the prescriptions you had filled, the cost of the drug and what you paid. The carrier keeps track of your total cost of prescriptions.

Remember, an Explanation of Benefits, no matter which plan you have, is not a bill.  If you owe anything, your provider will bill you. 

 

 

This is a confusing topic, but we are here to help you with all of your Medicare questions and to help you make the right choices for you.

Vickie Davidson

Vickie has been a KIG account manager for more than 15 years and is our resident Medicare expert. She lives in Myrtle Beach, SC, with her husband, and is our only remote team-member. Vickie loves getting to spend time with her grand kids and despite her location, is still a huge Pittsburgh sports fan.

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