A Medicare Advance Beneficiary Notice (ABN) is a written notice that healthcare providers must give you before providing services that Medicare may not cover. This notice allows you to make an informed decision about whether to receive the service and accept financial responsibility for payment.
Healthcare providers use the ABN form when they believe Medicare might deny payment for a specific service or item. Common situations include services that exceed Medicare frequency limits, services considered not medically necessary, or experimental treatments. The ABN clearly states the service being provided, the reason Medicare may not pay, and an estimate of what you might owe.
When presented with an ABN, you have three choices. You can receive the service and accept financial responsibility if Medicare denies payment, receive the service but ask the provider to submit a claim to Medicare anyway, or decline the service entirely. Your signature on the ABN confirms you understand your potential financial obligation.
The ABN protects both you and the provider. It ensures you won’t be surprised by unexpected bills and allows providers to collect payment for non-covered services.