- Section 1 Introduction
- Introduction
- Federal Government Administration
- Fundamentals of Medicare: State Responsibilities
- Fundamentals of Medicare: Participating Providers
- Voluntary and Involuntary Termination of Provider Agreement
- Disclosure of Health Insurance Information
- Privacy Act
- National Provider Identifier
- Legacy Provider Numbers/Provider Transaction Access Numbers (PTANs)
- Medicare Administrative Contractors
- Fundamentals of Medicare: Information References
- Acronyms
- Fundamentals of Medicare: Glossary of Terms
- Section 2 Medicare Basics
- The History of Medicare
- What Is the Medicare Program and How Is It Funded?
- Medicare Eligibility and Premiums
- The Social Security Administration and Medicare Enrollment
- The Medicare Card
- Medicare Part A
- Inpatient Hospital Care
- Skilled Nursing Facility Inpatient Care
- Home Health Care Benefit
- The Hospice Benefit
- Medicare Part B Medical Insurance
- Fundamentals of Medicare - Medicare Program Exclusions
- Medicare Advantage Organizations
- Medicare Secondary Payer
- Supplemental Insurance
- Coordination of Benefits Trading Partners
- Section 3 Fraud and Abuse
- Section 4 Getting Ready to Bill Medicare
Section 2: Medicare Basics
The Medicare Card
Once a person is enrolled in Medicare, they are issued a card that indicates they are covered by Medicare. The Medicare card is red, white and blue in color. It is issued (and can be reissued) through the SSA office. It contains the following information for the Medicare beneficiary:
- Full name
- Medicare claim number
- Entitlement to Hospital Insurance (Part A) with the respective effective date
- Entitlement to Medical Insurance (Part B) with the respective effective date
The Medicare claim number, often referred to as the “Medicare number” or Medicare Beneficiary Identifier/MBI is the only method by which a Medicare office can identify and verify the beneficiary’s entitlement to Medicare. A person’s Medicare number must be present on all claims submitted to Medicare. Providers are advised to make a photocopy of the card in order to be able to prepare accurate claims for submission to Medicare. They also should check the beneficiary’s entitlement records via their electronic connection to their Medicare claims processing office.
It is important to note that the Medicare card is not reissued if Medicare Part A or Medicare Part B is terminated for any reason. For example, if a beneficiary does not pay his/her premium, the card will still show an effective date. Also, the Medicare card does not indicate when a beneficiary elects a Medicare Advantage (MA) organization plan or the hospice benefit rather than traditional fee-for-service Medicare.
Beneficiaries who need a replacement card or have questions about enrollment in Medicare Part A or Part B may go to their local SSA office, visit the SSA website or call the SSA at 800-772-1213.
Revised 1/2021