Is a Medicare Summary Notice a bill?

No. It is a record of services billed to Medicare, what Medicare paid, and the maximum you may owe. You do not send payment in response to it. Any actual bill comes separately from your doctor or hospital.

How often do Medicare Summary Notices arrive?

Paper notices are now sent every six months, a change that took effect in January 2026. They were previously mailed quarterly and then every 120 days. You only receive one if you had services or supplies billed during that period. Electronic notices are available monthly through a Medicare.gov account.

How long do I have to appeal a denied claim on my Medicare Summary Notice?

You have 120 days from the date on the notice to request a redetermination, which is the first level of appeal. The instructions and address are on the last page of the notice. If you miss the deadline, you can ask for a good-cause extension, which is considered case by case.

Why does my Medicare Summary Notice come from a private company?

Medicare uses contractors to process claims, so the notice may carry an unfamiliar company name and address. This is normal and does not mean the notice is fraudulent.

Do Medicare Advantage members get a Medicare Summary Notice?

No. MSNs go to people with Original Medicare, Parts A and B. Medicare Advantage plans send their own explanation of benefits instead, issued by the insurer rather than by Medicare.

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Medicare Summary Notice: what it is, and why it is not a bill

Often shortened to MSN. Medicare's version of an explanation of benefits.

The short version: a Medicare Summary Notice is a record, not a bill. It lists the services billed to Medicare on your behalf over the past few months, what Medicare paid, and the most you might owe your provider. You do not send money in response to it. Any actual bill comes separately, from your doctor or hospital. Your job with an MSN is to read it and check it — and if something was denied or looks wrong, you have 120 days from the date on the notice to appeal.

Why people think it is a bill

Because it has dollar figures on it, including a line showing the maximum you may owe. That number is a ceiling, not a demand. It exists so that when a bill does arrive from your provider, you can check whether they are charging you more than Medicare says they are allowed to.

The notice also arrives from a private company rather than from Medicare directly. Medicare uses contractors to process claims, so the envelope and letterhead may carry an unfamiliar business name and address. That is normal and does not mean the notice is fake.

Who gets one

Medicare is federal health coverage, mainly for people aged 65 and over and for some younger people with disabilities. It comes in two shapes: Original Medicare, run directly by the federal government, and Medicare Advantage, run by private insurers under contract. Which one you have determines whether you get an MSN at all.

MSNs go to people with Original Medicare — Part A and Part B. If you are on a Medicare Advantage plan, you do not get an MSN. Your plan sends its own explanation of benefits instead, which looks similar but comes from the insurer.

You only receive one if you actually had services or supplies billed during the period. A quiet stretch with no appointments means no notice.

How often it arrives — this recently changed

MSNs used to be mailed quarterly. That changed to every 120 days, and from January 2026 paper notices are sent every six months. Medicare's own materials now describe it as at least twice a year.

A great many guides still say "quarterly." If you are wondering why yours has not arrived, this is usually the reason — nothing is wrong, the schedule simply changed.

If waiting six months feels too long to catch a billing error, you can switch to electronic notices. Sign in at Medicare.gov and choose eMSNs: you get an email for any month in which a claim was processed, rather than waiting for the paper cycle. Claims also appear in your online account well before the mailed version turns up.

What to actually check

Read it against your own memory and your provider's bills. Look for:

Services you never received. Appointments you cancelled, tests you did not have, equipment that never arrived.
Duplicates. The same visit or item billed twice.
Wrong dates of service.
A bigger service than you got. A short check-up billed as a lengthy consultation, for example.
Denied items. The notes section explains why something was not covered — this is where you find out whether you have grounds to appeal.
Amounts you already paid. If you paid your provider before the notice arrived, compare the two. Overpayments happen.

Small typos cause a surprising share of denials. A single wrong digit in a Medicare number can bounce an otherwise valid claim, and the fix is often just asking the provider's office to resubmit it correctly.

If something is wrong

Call your provider's office first. Most errors are billing or coding mistakes at that end, and they can resubmit the claim without any appeal at all. This resolves the majority of problems and costs you one phone call.

If that does not fix it, or if Medicare denied coverage for something you believe should be covered, you can appeal. The first level is called a redetermination, and the last page of your MSN gives step-by-step instructions and the address to send it to.

The 120-day deadline. You have 120 days from the date on the notice to request a redetermination. Note that the clock runs from the notice date, not from when you got round to opening it. Once the request is received, a decision is generally due within 60 days.

If you miss the deadline, it is still worth filing with an explanation — a good-cause extension can be granted for reasons such as the notice going to the wrong address or a serious illness. It is considered case by case, so a late appeal is not automatically a lost one.

How long to keep them

Hold onto an MSN at least until your provider's bill for those services arrives and is settled, so you can compare the two. Keeping them about a year after everything is resolved is a reasonable default. If you claim medical expenses on your tax return, keep them at least three years from filing, since that is the window in which returns are typically examined.

Is this letter real, or a scam?

The contractor letterhead confuses people, so here is the distinction. A genuine MSN:

Never asks you to pay anything. It is a statement. Any request for payment on an MSN-looking document is a red flag.
Does not ask you to confirm your Medicare number by phone or online.
Arrives by mail, or by email only if you signed up for electronic notices.

MSNs are also a tool against fraud. If yours lists services you never received, that can indicate someone is billing Medicare using your number. Report it on 1-800-MEDICARE rather than ignoring it — it costs you nothing directly, but it is worth stopping.

Free help exists

Every state runs a State Health Insurance Assistance Program (SHIP) offering free, unbiased Medicare counselling, including help reading notices and filing appeals. There is no charge and no sales pitch. For a disputed claim of any size, it is worth a call.

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Sources

Medicare Summary Notice (MSN) (Medicare.gov)
MSN mailings reduced to six months (Center for Medicare Advocacy)
Medicare Summary Notice (Medicare Interactive, Medicare Rights Center)

MyPlainLetter is an independent service. It is not affiliated with, authorized by, or endorsed by the Centers for Medicare & Medicaid Services or any other government agency. This page is general information about how Medicare Summary Notices work — it is not medical, legal, or insurance advice. For a decision about your own claim, contact Medicare or your State Health Insurance Assistance Program.