My provider asked me to sign an ABN. What does it mean, and which option should I pick?

Health insuranceWho paysChecked Nov 7, 2026

From K.Actuary, founded by Sangmin Kwon, ASA · sources checked 2026-11-07 · Source: Medicare.gov · Your Protections View original ↗

In short

An ABN warns that Medicare may not pay for a service.
Option 1 sends a claim, so you can still appeal.
An ABN is not a Medicare denial.

What this means

If you have Original Medicare, a provider may give you a written notice called an ABN if they think Medicare won't pay. It lists the items, a cost estimate, and why Medicare may not pay [1].

You must choose one option and sign [2]. Option 1: you want the service and want a claim sent to Medicare. If Medicare denies it, you pay, but you can appeal [2]. Option 2: you want the service but no claim is sent, so you can't appeal [2]. Option 3: you don't want the service, you don't pay, and you can't appeal [2].

An ABN is not an official denial by Medicare. You can appeal if a claim is sent and Medicare denies payment [3].

Your next step

Read the reason on the ABN before you sign. If you want the service and want to keep your right to appeal, choose Option 1 [2]. Keep a copy of the signed ABN. The sources give no deadline.

Check it yourself

Read the ABN's own directions for getting a Medicare decision and filing an appeal. If you have a Medicare Advantage plan, these sources do not cover its notices — "Don't know yet". Ask your State Health Insurance Assistance Program.

Where this comes from (3)

[1] Medicare.gov · Your Protections · checked 2026-11-07
This notice is called an “Advance Beneficiary Notice of Non-coverage,” or ABN. The ABN lists the items or services that your doctor or health care provider expects Medicare will not pay for, along with an estimate of the costs for the items and services and the reasons why Medicare may not pay.
[2] Medicare.gov · Your Protections · What can I do if I get this notice? · checked 2026-11-07
Option 1: You want items or services that Medicare may not pay for. Your provider or supplier may ask you to pay for these items or services now, but you also want your provider or supplier to submit a claim to Medicare. If Medicare denies payment: You’re responsible for paying. However, since a claim was submitted, you can appeal to Medicare. … Because you asked your provider or supplier not to submit a claim to Med…
[3] Medicare.gov · Your Protections · checked 2026-11-07
Remember, an ABN isn't an official denial of coverage by Medicare. You have the right to file an appeal if a claim is submitted and Medicare denies payment.

How we found this

We matched your question to 3 official sources, quoted the exact lines, and re-checked each quote against its source on 2026-11-07.

What we don’t know yet

Your own plan or notice may say something different. If your letter cites another rule, send it and we will look again.

Every answer is checked against the official rule it quotes.

Information only — not legal advice. Your plan, insurer or agency decides.

This answer quotes the official sources listed above, with the date we checked them. Your own policy, notice and state rules control. We are not your lawyer or your insurer. We don’t file, argue or negotiate claims for you — you send any letter or form yourself.

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