Your red, white, and blue Medicare card is a valuable resource, and the best evidence that you are enrolled in Medicare.
Most information on your Medicare card is straightforward and easy to understand. Other information is a little more confusing to some people with Medicare cards.
One item some Medicare recipients find confusing is their Medicare number, also called their Medicare Claim Number. This is the number every Medicare recipient should provide in all communication with the Social Security Administration about his or her Medicare account. This is also the number medical providers will need in order to provide Medicare-covered services to a Medicare recipient.
A recipient’s Medicare number is located on the front of every Medicare card right under the name of the beneficiary—and most people will recognize the numerical part of their Medicare number immediately.
The first nine digits of your Medicare Claim Number should match the nine digits of your Social Security Number. In some cases, however, those digits may match the nine digits of your spouse’s, parent’s, or child’s Social Security Number instead.
Whether the nine digits of your Medicare number match your Social Security Number or another person’s Social Security Number depends on the nature of your eligibility for Medicare. The nature of your eligibility for Medicare is also reflected in the letter code immediately following the numerical portion of your Medicare number.
Imagine your Medicare Claim Number is 123-45-6789. Unless another person is Medicare-eligible only through his or her relationship with you, you are the only person with a Medicare number beginning with 123-45-6789. If you are Medicare-eligible through your own payments into Medicare over 40 or more quarters, your Medicare number is 123-45-6789-A. More on that below.
In all, there are 12 letters that may follow the numerical part of a Medicare Claim Number. Another number can follow most of those 12 Medicare number suffix letters.
Besides the letter A, which indicates you are a primary claimant who has paid into the Medicare system as a wage earner, there are 33 other common codes that appear at the end of Medicare Claim Numbers to identify the nature of eligibility. There are also many less common codes, a list of which can be found in Section 50.3 of the Centers for Medicare & Medicaid Services publication on Medicare General Information, Eligibility, and Entitlement.
Note that if the letter A, B, C, or D follows the numerical part of your Medicare number, this has nothing to do with enrollment in Medicare Part A, B, C, or D. The front of your Medicare card indicates whether you are enrolled in Part A and/or Part B under the heading “IS ENTITLED TO.” If you are enrolled in a Medicare Part C (Medicare Advantage) plan or Medicare Part D (prescription drug) plan, that information appears on a separate card and not on your Medicare card. The letter A, B, C, or D following the numerical part of your Medicare number does not refer in any way to Medicare Part A, B, C, or D.
Following are the meanings of the primary letter codes on every Medicare card.
“A” means you are a retired wage earner and the primary claimant. Typically, you paid into the Medicare system during your working years over a period of at least 40 quarters.
“B” alone means you are the wife (62 years or older) of the primary claimant. Other Medicare suffixes in the “B” category include:
- B1 for the husband (62 years or older) of a primary claimant
- B2 for a young wife with a child in her care
- B3 for a second wife aged 62 or older
- B4 for a second husband
Numerical suffixes in the “B” category continue all the way to 9 (with B9 being the Medicare number suffix for a third husband). If your suffix code is anything in the “B” category, your spouse’s or ex-spouse’s Social Security Number, and not your own, will constitute the first nine numbers of your Medicare Claim Number.
“C” indicates you are the child of a primary claimant. Numerical suffixes following “C” indicate which child you are in relation to the primary claimant. If you are the first child, your suffix is C1; if you are the second child, your suffix is C2; if you are the third child, your suffix is C3; and so on. In all, numerical suffixes following C go all the way to number 9, depending on the order of birth of siblings. If your suffix code is anything in the “C” category, your primary claimant parent’s Social Security Number, and not your own, will constitute the first nine numbers of your Medicare Claim Number.
“D” alone indicates you are the widow of a primary claimant. D1, meanwhile, means you are a primary claimant’s widower.
Other Medicare suffixes in the “D” category include:
- D2 for the second widow of a primary claimant
- D3 for the second widower of a primary claimant
- D4 for certain remarried widows
- D5 for certain remarried widowers
- D6 and D7 for certain surviving divorced wives
Regardless of which “D” code may apply to you, the primary claimant’s Social Security Number, and not your own, will constitute the first nine digits of your Medicare number.
“E” alone indicates you are the widowed mother of a primary claimant. Other suffixes in the “E” category include E1 for the surviving divorced mother of a primary claimant; E2 for the second widowed mother of a primary claimant; E3 for the second divorced mother of the primary claimant; E4 for the primary claimant’s widowed father; and E5 for the primary claimant’s surviving divorced father. “E” may be a particularly complicated category given these convoluted variations. In all cases, the primary claimant’s Social Security Number will constitute the first nine digits of a Code “E” claimant’s Medicare number.
“F” is the parent category, with suffixes for a primary claimant’s father (F1), mother (F2), stepfather (F3), stepmother (F4), adoptive father (F5), and adoptive mother (F6). There is no “F” suffix without a number following it. The primary claimant child’s Social Security Number will constitute the first nine digits of a Code “F” claimant’s Medicare number.
“H” indicates Medicare eligibility due to disability. HA means you are a disabled claimant. HB means you are the wife of a disabled claimant. HC means you are the child of a disabled claimant. If you are an HA-category Medicare recipient, your Social Security Number appears in your Medicare number. If you are an HB or HC recipient, meanwhile, your disabled spouse’s or parent’s Social Security number constitutes the first nine digits of your Medicare number.
Codes “J” and “K”
Either of these suffixes indicates you are a “special beneficiary.” Medicare entitlement under Code J or K depends on your work history, and specifically on the number of quarters of employment that have been reported to Social Security. Suffixes of JI, J2, K1, and K2 indicate entitlement to Medicare Part A. J3, J4, K3, and K4 suffixes, meanwhile, entitle you to purchase Medicare Part A coverage.
“M” alone indicates you are enrolled in Medicare Part B but are not eligible for Medicare Part A coverage. To receive Part A coverage you must purchase it. M1 indicates you are enrolled in Part B and are also eligible for coverage under Medicare Part A but have refused Part A coverage.
“T” may indicate that you are eligible for Medicare Part A benefits but are not eligible for retirement benefits. Your eligibility for Medicare Part A applies whether you are or are not currently enrolled in Medicare Part B. “T” may also indicate that your Medicare eligibility is a result of chronic kidney disease. Again, you are eligible for Part A coverage whether you are or are not enrolled in Part B, but you are not eligible for retirement benefits. TA indicates Medicare eligibility due to Medicare Qualified Government Employment (MQGE), and TB indicates you are the spouse of a Medicare Qualified Government Employee.
“W” alone indicates you are the disabled widow of a primary claimant. Other Medicare suffixes in the “W” category include:
- WI for a primary claimant’s disabled widower
- W2 for a second widow
- W3 for a second widower
- W6 for a surviving disabled second wife
- W7 for a second disabled surviving second wife
For further information about Medicare letter codes and other Medicare symbols, you can contact the Medicare Administration toll-free at 1-800-MEDICARE (1-800-633-4277). Of course, it doesn’t hurt to have your Medicare number handy when doing so.
Is there anything else about your Medicare card that seems confusing? Leave a comment below.
What Do Those Extra Letters on Your Medicare Card Mean?© 2013 MedicareMall.com