An Advance Beneficiary Notice (ABN), is also known as a waiver of liability. It is an advance written notice of non-coverage that a provider should give you before you receive a service if based on Medicare coverage rules, your provider has reason to believe Medicare will not pay for the service. That way a Fee-For-Service (FFS) beneficiary should be able to make an informed decision in advance about items and/or services that are usually covered by Medicare, but may not be expected to be paid by Medicare in a specific instance for certain reasons, such as lack of medical necessity.
You may receive an ABN if you have Original Medicare, but not if you have a Medicare Advantage Plan. The ABN may look different, depending on the type of provider who gives it to you.
To recap: The ABN allows the beneficiary to make an informed decision in advance about whether to get the item and/or service that may not be covered by Medicare and accept financial responsibility themselves, if Medicare does not pay. If the beneficiary does not get written notice when it is required, he or she may not be held financially liable if Medicare denies payment, and the provider or supplier may be financially liable if Medicare does not pay.1
The Advance Beneficiary Notice must list the reason why the provider believes Medicare will deny payment. Providers are not required to give you an ABN for services or items that are never covered by Medicare, such as hearing aids.
For more information you can download a 13 page PDF document from the CMS.gov website at:
https://www.cms.gov/Outreach-and-Education/.../abn_booklet_icn006266.pdf
1. Source: https://www.cms.gov/Outreach-and-Education/.../abn_booklet_icn006266.pdf
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