Medicare beneficiaries receive multiple notices. Some of these require a response; others do not. Some are standard notices that are sent out regularly; others are unique to your situation. To help you make sense of the letters you get, here’s some information on a few of the most common forms.
Every three months, CMS sends out a Medicare summary notice to people enrolled in Medicare Part A and Part B. It simply lists any services or supplies that you received, shows what Medicare paid and tells you the maximum amount the provider may charge you. If you did not receive any supplies or services, you won’t receive a summary notice.
This notice is not a bill and does not require any action on your part. However, to ensure you’re not overpaying, it’s smart to check the numbers against your own records. If a claim is denied or your provider charged you more than the maximum amount indicated by CMS, you will need to call your provider to see if there was a problem and what can be done about it.
Advance Beneficiary Notice of Noncoverage
These notices come from your provider and state that Medicare is not expected to cover a service or supplies. If you receive an Advance Beneficiary Notice of Noncoverage, you have to decide whether you want to receive the services and have the provider try to bill Medicare, you want to receive the services without billing Medicare or you don’t want the services.
Extra Help Notice
Medicare has several notices that can be sent to people receiving Low-Income Subsidies, sometimes called “Extra Help,” listed here. The Low-Income Subsidies help beneficiaries pay for Medicare Part D prescription coverage. Qualification for the program is based on income and assets. You can apply online, but some people qualify automatically.
Some of the Extra Help notices are color coded for you convenience.
- Purple: These notices inform you of automatic qualification.
- Yellow or Green: These notices inform you of automatic enrollment.
- Orange: These notices inform you of a change in your copayment amount for the next year.
- Gray: These notices inform you that you no longer qualify automatically. You can still apply for coverage, but you have to take action if you want to try to retain your Extra Help.
Other forms may notify you that your plan coverage is ending and you need to choose another plan, among other things.
Medicare sends out a lot of letters. What they don’t do is call you out of the blue to demand personal information or money. If you receive a dubious call from someone claiming to be from Medicare, do not give out personal information or agree to send money. It’s likely a scam. Call Medicare directly if you’re worried there’s a problem or would like to report fraud.