Medicare does not cover everything. People on Original Medicare will get a written notice from their medical provider before they receive a service or equipment to let them know if it will be covered by Medicare. This notice is called an Advance Beneficiary Notice of Noncoverage or ABN.
An ABN is not required if the equipment or service is never covered by Medicare, such as dental care, and is only required for those with Original Medicare and not for those with a Medicare Advantage Plan. If you are given an ABN form you must choose one of the three options.
You agree to pay for the item or service, but request the provider submit the claim to Medicare. This allows you the right to appeal if Medicare denies payment.
You agree to pay for the item or service and do not want the claim submitted to Medicare.
You decline the service or item, and no claim is submitted.
An ABN is not a denial of payment. Instead, it is a warning to you that the service or item you will be receiving may not be covered. If a claim was submitted, you will receive a Medicare Summary Notice (MSN) showing whether the claim was paid. If the claim was denied, you can follow the instructions on the MSN to file an appeal with Medicare.
People who have questions or want help in appealing a denied claim can call the Senior LinkAge Line® at 800-333-2433.
