What do the new Medicare cards mean for States?
If you’re a state Medicaid agency in any state, the District of Columbia, or a U.S. territory, you need to get ready to use the new Medicare Beneficiary Identifier (MBI) for your beneficiaries with Medicare and Medicaid (also known as “dual eligible” beneficiaries).
When do states need to be ready for the new Medicare cards?
We're mailing the new Medicare cards with the MBI to all people with Medicare. This means all of your systems will need to be ready use the Health Insurance Claim Number (HICN) and/or MBI for beneficiaries who are dually eligible beginning in April 2018. You’ll need to make changes to your systems before October 2017 so you have enough time to test them.
There's a transition period where you can use either the HICN or the MBI to exchange data with us. The transition period will begin no earlier than April 1, 2018 and run through December 31, 2019.
After the transition period, you’ll have to use the dually eligible beneficiaries’ MBIs with us, providers, beneficiaries, and other partners. Medicaid providers have to use MBIs in all transactions and all communications about dually eligible beneficiaries starting on January 1, 2020 with very few exceptions.
During the transition period, we’ll process and transmit Medicare crossover claims with either the HICN or MBI. For crossover claims processing, during and even after the transition period, we’ll keep sending you plan membership IDs like we do now. We’re planning to use 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're ready for Medicare crossover claims.
How will CMS help states get ready for the new Medicare cards?
To help you get ready and have a smooth transition, we’ve:
- Worked with you to get the 90% federal match for new Medicare card policy, systems remediation, development and systems testing. Our regional offices can give you details.
- Made a timeline and gave you guidance about how to follow it.
- Shared critical readiness factors and testing guidelines.
- Shared communication plans and tools for coordinated outreach.
- Held and will continue bi-weekly all-state forum calls to give you help with implementing the new Medicare cards and let you know about education and outreach.
We also reached out to our Managed Care plans to make sure they know about the new Medicare card requirements and timelines. You should also work with your Medicaid managed care organizations, providers, and other stakeholders for a smooth transition.
What do new Medicare cards mean for other state entities & state partners?
If you work with beneficiaries who are dually eligible, providers, and/or health plans, update anything with the HICN, such as ID cards, beneficiary letters, training materials, or call center scripts with the MBI.
Your state Medicaid agency can give you more about state-specific information about getting ready for the new Medicare cards.
Where can states get more information about the new Medicare cards?
Check back here often; we’ll update this webpage when we’ve got new information to share.
Read our frequently asked questions.
- Page last Modified: 05/03/2018 5:12 PM
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