advance beneficiary notice (ABN)

ABNs do not have to be provided for care that’s never covered by Original Medicare, such as routine dental and vision care, hearing aids, or custodial long-term care. Instead, ABNs are used for care that can be covered by Medicare, but that the medical provider believes will not be covered in the patient’s situation.²

If your doctor or medical supplier gives you an ABN, it will include the reason the provider believes that Medicare won’t cover the service. You can decide to go ahead with the care in question, but the ABN lets you know that you may be responsible for the cost, since Medicare may deny the claim. You can still ask the provider to submit the claim to Medicare, and Medicare may cover it. If not, however, you’ll have to pay for the care yourself.