CMS will be removing Social Security Numbers from Medicare cards to prevent fraud, fight identitiy theft, and keep taxpayer dollars safe. They will be mailing the new Medicare cards from April 2018 through April 2019. Click here to view how CMS will be mailing the new Medicare cards in phases by geographic location.
New Medicare Cards
The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015, requires CMS to remove Social Security Numbers (SSNs) from all Medicare cards by April 2019. A new Medicare Beneficiary Identifier (MBI) will replace the SSN-based Health Insurance Claim Number (HICN) on the new Medicare cards for Medicare transactions like billing, eligibility status, and claim status. You can find more details in our 5/30/17 press release and latest Open Door Forum slides. Also, you can see the new card on our new Medicare card homepage.
CMS currently uses an SSN-based HICN to identify people with Medicare and administer the program. They've used the HICN with our business partners:
- The Social Security Administration (SSA)
- The United States Railroad Retirement Board(RRB)
- State Medicaid Agencies
- Health care providers
- Health plans
Under the new system, for each person enrolled in Medicare, CMS will:
- Assign a new MBI.
- Mail a new Medicare card.
The MBI is confidential like the SSN and should be protected as Personally Identifiable Information.
Why are the new Medicare cards important?
The biggest reason CMS is taking the SSN off of Medicare cards is to fight medical identity theft for people with Medicare.
By replacing the SSN-based HICN on all Medicare cards, CMS can better protect:
- Private health care and financial information.
- Federal health care benefit and service payments.
They've often heard from Congress, the General Accountability Office, people with Medicare, and advocacy groups that they want the SSN taken off Medicare cards.
CMS plans to have a transition period where you can use either the HICN or the MBI to exchange data with them. The transition period will begin no earlier than April 1, 2018 and run through December 31, 2019.
During the transition period, we’ll monitor the use of HICNs and MBIs to see how many of you are ready to use only MBIs by January 2020. They’ll also actively monitor the transition and adjustment to the new MBIs to make sure of their wide-spread adoption so Medicare operations aren’t interrupted.
Starting January 1, 2020, you have to submit claims using MBIs (with a few exceptions), no matter what date you performed the service.
Medicare plan exceptions:
- Appeals - People filing appeals can use either the HICN or the MBI for their appeals and related forms.
- Adjustments - You can use the HICN indefinitely for some systems (Drug Data Processing, Risk Adjustment Processing, and Encounter Data) and for all records, not just adjustments.
- Reports - We’ll use the HICN on these reports until further notice:
- Incoming to us (quality reporting, Disproportionate Share Hospital data requests, etc.)
- Outgoing from us (Provider Statistical & Reimbursement Report, Accountable Care Organization reports, etc.)
Fee-for-Service claim exceptions:
- Appeals - You can use either the HICN or the MBI for claims appeals and related forms.
- Claim status query - You can use either the HICN or MBI to check the status of a claim (276 transactions) if the earliest date of service on the claim is before January 1, 2020. If you're checking the status of a claim with a date of service on or after January 1, 2020, you have to use the MBI.
- Span-date claims -You can use the HICN for 11X-Inpatient Hospital, 32X-Home Health (home health claims & Request for Anticipated Payments (RAPs)), and 41X-Religious Non-Medical Health Care Institution claims if the “From Date” is before the end of the transition period (12/31/2019). You can submit claims received between April 1, 2018 and December 31, 2019 using the HICN or the MBI. If a patient starts getting services in an inpatient hospital, home health, or religious non-medical health care institution before December 31, 2019, but stops getting those services after December 31, 2019, you may submit a claim using either the HICN or the MBI, even if you submit it after December 31, 2019.
- Incoming premium payments - People with Medicare who don't get SSA or RRB benefits and submit premium payments should use the MBI on incoming premium remittances. But, we'll accept the HICN on incoming premium remittances after the transition period. (Part A premiums, Part B premiums, Part D income related monthly adjustment amounts, etc.)
How will the MBI look?
The MBI will be:
- Clearly different than the HICN and RRB number
- 11-characters in length
- Made up only of numbers and uppercase letters (no special characters); if you use lowercase letters, our system will convert them to uppercase letters
Learn about and use our MBI format specifications to make changes to your systems.
Will the MBI's characters have any meaning?
Each MBI is unique, randomly generated, and the characters are "non-intelligent," which means they don't have any hidden or special meaning.
What do the new Medicare cards mean for people with Medicare?
The MBI won’t change Medicare benefits. People with Medicare may start using their new Medicare cards and MBIs as soon as they get them.
The effective date of the new cards, like the old cards, is the date each beneficiary was or is eligible for Medicare.
Once beneficiaries get their new Medicare cards with an MBI, they can use their new cards to enroll in a Medicare health (Medicare Advantage) or drug plan. Those Medicare beneficiaries who do choose to enroll in Medicare health and/or drug plans will still also get an insurance card from their health and/or drug plans. As always, while beneficiaries are enrolled in health and/or drug plans, they should use the cards from those plans when they get health care and/or prescriptions.
See our new Medicare card Partners & employers page for resources you can use when you talk to people with Medicare about the new Medicare cards.
Where can I get more information about the new Medicare cards?
Get CMS's Open Door Forum materials and check this webpage often for updates.