Other payers

What do Medicare Beneficiary Identifiers (MBIs) mean for other payers?

Medicaid & supplemental insurers

We've given State Medicaid Agencies and supplemental insurers the MBIs for Medicaid-eligible people who also have Medicare. During the transition period, we're processing and transmitting Medicare crossover claims with either the Health Insurance Claim Number (HICN) or Medicare Beneficiary Identifier (MBI).

We’re using a crosswalk that shows you HICNs and the MBIs that go with them. So, if you use HICNs for crossover claims processing, you also have access to MBIs. For crossover claims processing, during and even after the transition period, we’ll keep sending you state ID numbers like we've been doing.

Private payers

For non-Medicare business, private payers won’t have to use the MBI. If you're a supplemental insurer, we’ll continue using your unique numbers to identify your customers, but after the transition period, you must use the MBI for any Medicare transactions where you would have used the HICN.

Even though we’re using MBIs for claims and other Medicare business, this change shouldn’t affect how you're using Social Security numbers (SSNs) to identify and verify your members.  

You don’t need to change your members’ ID numbers unless those ID numbers include whole or parts of their SSNs. We urge you to keep using the unique identifiers that you’ve been using and not to include MBIs on your members’ ID cards.

During the transition period, when you submit claims using beneficiaries’ valid and active HICNs, we’ve been returning both the HICN and the MBI on every remittance advice. If you send a HICN after the transition period’s over, we won’t send you a new transaction reply code. MARx is sending you the same transaction code (008) when a health insurance claim number can’t be found.





MBI Home

Page Last Modified:
11/13/2019 06:09 PM