Medicare Glossary

ABN (Advance Beneficiary Notice of Noncoverage)

A written notice that a doctor or supplier gives you before providing a service that Medicare may not pay for. If you sign the ABN, you agree to pay for the service yourself if Medicare denies the claim. You have the right to refuse the service.

Also known as: ABN, Advance Beneficiary Notice

Assignment

An agreement by a doctor, supplier, or provider to accept the Medicare-approved amount as full payment for a covered service. Providers who accept assignment cannot bill you for more than that amount, aside from normal deductibles and coinsurance.

Non-participating Provider

A doctor or supplier who does not accept Medicare assignment but is still enrolled in Medicare. They may charge up to 15% more than the Medicare-approved amount (the limiting charge). Medicare will still pay its share, but you may pay more.

Also known as: Non-par provider

Out-of-Network

Providers, facilities, or suppliers that do not have a contract with your health plan. Using out-of-network providers often costs more. Some Medicare Advantage plans (like PPOs) allow out-of-network use at higher cost; others (like HMOs) generally do not.