Managing Your Practice

New Medicare cards


By now, you are probably aware that the Centers for Medicare and Medicaid Services has begun the process of switching out old Medicare cards (and numbers) for new ones. The new, completely random number-letter combinations – dubbed Medicare Beneficiary Identifiers (MBI) – replace the old Social Security number–based Health Insurance Claim Numbers (HICN). The idea is to make citizens’ private information less vulnerable to identity thieves and other nefarious parties.

The switch began on April 1, and is expected to take about a year as the CMS processes about half a dozen states at a time. As I write this (at the beginning of May), the CMS is mailing out the first group of new cards to patients in Pennsylvania, Virginia, West Virginia, Maryland, Delaware, and the District of Columbia. But regardless of where you practice, you can expect to start seeing MBIs in your office soon – if you haven’t already – because people enrolling in Medicare for the first time are also receiving the new cards, no matter where they live.

Unlike the abrupt switch in 2015 from ICD-9 coding to ICD-10, this changeover has a transition period: Both HICNs and MBIs can be used on all billing and Medicare transactions from now until the end of 2019; after that, only claims with MBIs will be accepted. The last day of 2019 may sound like a long way off, but the time to get up to speed on everything MBI is now. That way, you can begin processing MBIs as soon as you start receiving them, and you will have time to solve any processing glitches well before the deadline.

First, you’ll need to make sure that your electronic health records and claims processing software will accept the new format, and that your electronic clearinghouse, if you use one, is geared up to accept and transmit the data on the new cards. Not all of them are. Some have been seduced by the year-and-a-half buffer – during which time HICNs can still be used – into dragging their feet on the MBI issue. Now is the time to find out if a vendor’s software is hard-wired to accept a maximum of 10 digits (MBIs have 11), not when your claims start bouncing.

Second, you will need to educate your front desk staff, so they will be able to recognize the new cards at a glance. Unfortunately, it looks a lot like the current card, though it is slightly smaller. It has the traditional red and blue colors with black printing, but there is no birthday or gender designation – again, in the interest of protecting patients’ identities. Knowing the difference will become particularly important after your state has been processed, when all of your Medicare patients should have the new card. Those who don’t will need to be identified and urged to get one before the December 2019 deadline.

Current and new Medicare cards Centers for Medicare & Medicaid Services

Finally, once your staff and vendors are up to speed, you can begin educating your patients. Inevitably, some will not receive a new card, especially if they have moved and have not notified the CMS of the change; and some who are not expecting a new card will believe it is a duplicate, and throw it away. The CMS will be airing public service announcements and mailing education pieces to Medicare recipients, but a substantial portion of the education burden will fall on doctors and hospitals.

Have your front office staff remind patients to be sure their addresses are updated online with Medicare ( or the Social Security Administration ( Encourage them to take advantage of the free resources available at These include both downloadable options and printed materials that illustrate what the new card will look like, explain how to update a mailing address with the Social Security Administration, and remind seniors to keep an eye out for their cards in the mail.


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