Share of Cost, Keep track of what you may owe for your health and drug benefits, and identify if additional action is needed.
When reviewing your Medicare statements, identify the services or medications you have received and your share of the cost for each item. Your statement will clearly mark the services received, the amount that Medicare or your plan will cover, and the maximum amount that you can be billed for the service. These statements will also list if Medicare or your plan has denied coverage for care or medications you have received. It is important to check your statements for any denials of coverage. Your provider will also send you a separate bill for any fees you owe.
If you see a denial, call your provider to ensure that the service was billed to Medicare correctly. If the service was billed correctly and is being denied, follow the instructions on your statement to file an appeal. If you need assistance with denials, appeals, or understanding your coverage, contact your local Health Insurance Counseling and Advocacy Program (HICAP). If you do not think you received the service, item, or medication outlined on your MSN or EOB, contact your provider to inquire about a possible error. If you are unable to resolve the issue with your provider, contact our Senior Medicare Patrol (SMP) to discuss potential abuse or fraud at 1-855-613-7080.