What are Advance Beneficiary Notices?

What are Advance Beneficiary Notices?

November 4, 2022 in

Medicare covers medically necessary services and certain preventive services. Please visit medicare.gov for specific benefit coverage information.

Advance Beneficiary Notice (ABN), is used to inform you that Medicare may not cover a service because it does not meet their definition of medically necessary. The purpose of the form is to help you make an informed decision.

• For these services, you must be notified in advance that the service will likely not be covered.
• The notice must include what test or services will likely not be covered, as well as an estimate of the cost of those services.
• If you choose to have the test or service, even though Medicare is unlikely to pay for it, you will receive a bill for the service(s) if Medicare does not pay for them.

Because Medicare is unlikely to pay for the service does not mean that you should not receive it. There may be a good reason your provider ordered the service.