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 using the new Medicare Beneficiary Identifier (MBI) for your beneficiaries who are dually eligible for both Medicare and Medicaid.
When did states need to be ready for the new Medicare cards?
We mailed the new Medicare cards with the MBI to all people with Medicare. This means all of your systems should be able to accept and are using the Health Insurance Claim Number (HICN) and/or MBI for beneficiaries who are dually eligible.
There's a transition period where providers, plans, beneficiaries, and other partners can use either the HICN or the MBI to exchange data with us. The transition period started on April 1, 2018 and will run through December 31, 2019.
After the transition period, providers, plans, beneficiaries, and other partners must use the dually eligible beneficiaries’ MBIs with us. 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 to State Medicaid Agencies and other COB payers 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 or state Medicaid recipient IDs, like we always have.
For those that rely on the Medicare identifier instead of the State Medicaid ID, we'll keep providing both the HICN and MBI to State Medicaid Agencies and other COB payers through COBA eligibility response files, unless the beneficiary only ever had an MBI. In that case, we'll only provide the MBI.
How did 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.
- 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 education and outreach.
- Held and will continue All-State forum calls to give you help with implementing the new MBIs.
We also reached out to our Managed Care plans to make sure they know about the new Medicare number and card requirements and timelines. You should have also worked 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, you should have updated 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?
Read our frequently asked questions.
- Page last Modified: 01/16/2019 10:44 AM
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