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Other payers


What do the new Medicare cards mean for other payers?

Medicaid & supplemental insurers

We’ll give State Medicaid Agencies and supplemental insurers the MBIs for Medicaid-eligible people who also have Medicare before we mail the new Medicare cards. During the transition period, we’ll process and transmit Medicare crossover claims with either the Health Insurance Claim Number (HICN) or Medicare Beneficiary Identifier (MBI).

We’re using a crosswalk that’ll show you HICNs and the MBIs that go with them. So, if you use HICNs for crossover claims processing, you’ll also have access to MBIs so you’ll be ready for Medicare crossover claims starting in April 2018. For crossover claims processing, during and even after the transition period, we’ll keep sending you state ID numbers like we do now.

Private payers

For non-Medicare business, private payers won’t have to use the MBI. If you are a supplemental insurer, we’ll continue to use 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 use 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.

Starting in October 2018, through the transition period, when you submit claims using beneficiaries’ valid and active HICNs, we’ll return 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 will send you the same transaction code that that’s sent now (008) when a health insurance claim number can’t be found.

We’re using a crosswalk that’ll show you HICNs and the MBIs that go with them. So, if you use HICNs for crossover claims processing, you’ll also have access to MBIs so you’ll be ready for Medicare crossover claims. For crossover claims processing, during and even after the transition period, we’ll keep sending you plan membership IDs like we do now.

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