CMS announces new Medicare Summary Notice (sometimes referred to as an Explanation of Benefits)

I am an experienced health benefits professional yet at times I have trouble understanding what Medicare paid on a claim, what my supplemental coverage will pay and what I am responsible to pay. Medicare has looked at this issue and has redesigned the statement beneficiaries receive explaining their benefits.

I have to say, good job! Many private carriers can take a hint from this design. At the bottom of this post you can link to the new Summary Notice.

Medicare redesigns claims and benefits statement

As part of National Consumer Protection Week, the Acting Administrator of the Centers for Medicare & Medicaid Services (CMS), Marilyn Tavenner, announced the redesign of the statement that informs Medicare beneficiaries about their claims for Medicare services and benefits. The redesigned statement, known as the Medicare Summary Notice (MSN), will be available online and, starting in 2013, mailed out quarterly to beneficiaries.

This MSN redesign is part of a new initiative, “Your Medicare Information: Clearer, Simpler, At Your Fingertips,” which aims to make Medicare information clearer, more accessible, and easier for beneficiaries and their caregivers to understand. CMS will take additional actions this year to make information about benefits, providers, and claims more accessible and easier to understand for seniors and people with disabilities who have Medicare. This MSN redesign reflects more than 18 months of research and feedback from beneficiaries to provide enhanced customer service and respond to suggestions and input.

“Consumer protection starts with making sure consumers not only get timely and accurate information, but that they understand what services they’re receiving from Medicare,” said Acting Administrator Tavenner. “The new Medicare Summary Notice empowers Medicare’s seniors and people with disabilities. The statement is easier to understand and navigate, and makes clear what information to check and how to report potential fraud. The new MSN also makes it easier for people with Medicare to understand their benefits and file appeals if a claim is denied.”

To see a side-by-side comparison of the former and redesigned MSNs, please visit:

New Medicare Summary Notice

The redesign of the MSN includes several features not currently available to Medicare beneficiaries with the current MSN:
· A clear notice on how to check the form for important facts and potential fraud;
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· Clearer language, including consumer-friendly descriptions for medical procedures;
· Definitions of all terms used in the form;
· Larger fonts throughout to make it easier to read;
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Starting later this week, the redesigned MSN will be available to beneficiaries on mymedicare.gov, Medicare’s secure online service for personalized information regarding Medicare benefits and services; and, in early 2013, paper copies of the redesigned MSN will start to replace the current version being mailed.

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