A Medicare waiver, which is also known as an ABN (Advance Beneficiary Notice) is a document given to you before getting certain items or services, to notify the Medicare-covered patients of possible non-coverage. It can be that Medicare may deny payment for specific services or medical devices and that the patient is responsible for the full payment incurred.
Although you may be covered under Medicare, there are services and equipment deemed necessary for your treatment that may not be covered. Some examples of this are vision care and many alternative medical practices. There are some expenses covered but with limitation, in which case the Medicare Waiver will also apply. Some items are only covered for a certain number of times within a given amount of time. Examples of these are laboratory tests, some preventive screening tests and vaccinations.
A Medicare waiver is not an indication that treatment or equipment is being refused. It is merely informing the patient that there are expenses incurred that may have to be borne by the patient. The ABN gives an opportunity to either accept or reject the services or equipment and protects the person from unexpected liability. The patient is offered the right to appeal Medicare's decision of non-payment.
In the event of receiving a Medicare waiver or ABN, the patient should first contact the physician prescribing the service or device, to see if there are alternatives that can be considered. The physician can also play a crucial role in the appeal process to convince that the treatment is medically relevant for the person.