Mitigating Medicare Mishaps

Medicare numbers, also called Health Insurance Claim (HIC) numbers, are almost always 9 digits with a letter suffix, such as 000-00-0000A. The HIC is the wage earner’s Social Security Number (SSN), which could be either the patient’s, a spouse’s or a parent’s SSN. Because of this, you can’t assume that the patient’s Medicare number is always their SSN+A. It is important that you have them read the number to you from their card if updating the patient on the phone, or that you see the card if you have the patient in front of you.

In some instances, HIC numbers can change, though usually it is only the ending letter. For example, a patient receiving spousal benefits (spouse’s SSN + B) will have their Medicare number change to a survivor’s benefit (spouse’s SSN + D) when the spouse expires. For this reason, you should always update a patient’s Medicare number as you would any other insurance when registering. This is also a good time to make sure the patient does not have a Medicare Replacement/Advantage Plan.

In some computer systems, when entering a HIC number it is important make sure there are no leading spaces. If there is a number following the suffix, such as B2, a leading space will keep the number 2 from transferring to billing software. This may delays claim processing and create more work for billers. For this reason, it is also a good practice not to have leading spaces in any insurance ID.

More Medicare Trivia (or Muddling Through the Medicare Miasma)

Railroad Retiree Medicare numbers have a letter prefix, such as MA000-00-0000.

Typical Medicare HIC Suffixes include the following:
A —patient’s SSN (wage earner)
B —spouse of wage (also B1 through B9!)
C —child (could be followed by a number or letter)
D —widow (could be followed by a number or letter)
E —mother/widow (could be followed by a number or letter)
F– F1 Father, F2 Mother, F3 Stepfather, F4 Stepmother, F5 Adopting father, F6 Adopting mother, F7 Second alleged father, F8 Second alleged mother
K —receiving wife’s special age 72 benefits through her husband (could be followed by a number or letter)
J1 —receiving special age 72 benefits (also J2, J3, and J4)
M —has enrolled in Part B ONLY, but receives no monthly Social Security benefits (also M1)
T —has enrolled in Part A and possibly Part B, but receives no monthly Social Security benefits (could be followed by a number or letter)
W —disabled widow/widower (could be followed by a number or letter)

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