When you are enrolled in Original Medicare, your physician, healthcare provider, or supplier might provide you with a written document if they believe Medicare will not cover the costs for your healthcare goods or services. This document is referred to as the “Advance Beneficiary Notice of Noncoverage,” or ABN for short. The ABN enumerates the goods or services that your physician or healthcare practitioner anticipates Medicare will not reimburse, and it includes a cost estimate for these goods or services, as well as the justifications for Medicare’s anticipated nonpayment.
What are the implications of receiving an ABN?
- You will have the option to decide whether to receive the goods or services mentioned in the notice.
- If you elect to proceed with the goods or services on the notice, you acknowledge your financial responsibility should Medicare refuse payment.
- You will need to sign the notice to indicate that you have comprehensively read and grasped its contents.
- Physicians, healthcare providers, and suppliers are not required (though they may still opt) to issue a notice for services that are consistently not covered by Medicare.
- An ABN should not be mistaken for a formal denial of coverage from Medicare. If Medicare declines the payment, you retain the right to contest the decision after receiving the “Medicare Summary Notice” (MSN) that includes the disputed good or service. Nonetheless, if Medicare ultimately deems the goods or services non-coverable, and no other insurer is accountable, the costs will be your responsibility.
