What do Medicare Beneficiary Identifiers (MBIs) mean for plans?

Medicare health and drug plans contracting or working with us should be using Medicare Beneficiary Identifiers (MBIs). 

You don’t need to change your members’ ID numbers unless those ID numbers include whole or parts of their Social Security Numbers. We urge you to keep using the unique identifiers that you’ve been using and not to include MBIs on your members’ ID cards.

How should plans get MBIs?

If you send a HICN now that the transition period's over, we won’t send you a new transaction reply code. MARx will send you the same transaction code that that’s sent now (008) when a health insurance claim number can’t be found.  

How should plans use MBIs?

Even though we’ve moved to MBIs for claims and other Medicare business, this change didn't affect how you use Social Security numbers (SSNs) to identify and verify your members.

Crossover claims

Through Medicare's Coordination of Benefits Agreement (COBA) crossover process, we shared a crosswalk with COBA trading partners (supplemental insurers, Medigap plans, Medicaid, etc.) that’ll show them their covered members' and benefit recipients' HICNs and the MBIs that go with them.Medicare’s COBA administrative contractor, the Benefits Coordination & Recovery Center (BCRC), also supports a query process that lets COBA trading partners get MBIs for those people with Medicare who didn’t have an MBI when the trading partners got the HICN—to—MBI crosswalk file.  Both of these tools make sure COBA trading partners can use the MBI on Medicare crossover claims after January 1, 2020.  They also make sure COBA trading partners can accept HICNs on Medicare crossover claims where exceptions apply.

For Medicare fee-for-service crossover claims after January 1, 2020, Medicare will keep sending COBA trading partners their plan membership IDs or state Medicaid recipient IDs, as applicable, as we’ve done in the past. We're not adding beneficiaries who’ve cancelled their plan enrollment and have never existed in the plan to the MARx Crosswalk File. We’re only adding those beneficiaries who are now enrolled or were enrolled in a plan to the MARx Crosswalk File.

Using the card image

You can keep using the Medicare card image in your plan materials, and in digital formats like video, on the web, or however you need to for business purposes. Here's a high resolution image of the card (PDF) or you can use a generic card image you've made in videos or in other online or electronic materials. We're not providing a generic image for use. 

You don’t have to resubmit marketing materials that have already been approved or accepted if the only change you've made is to update the Medicare card image.

You can't alter the Medicare card image in any way, but you can use a black and white version of the image for print materials.

How do plans protect MBIs?

Like SSNs and Health Insurance Claim Numbers (HICNs), MBIs are confidential and should be protected as Personally Identifiable Information. Here’s how plans should be protecting the integrity of MBIs:

Don’t give MBIs over the phone

Plan call centers shouldn’t give MBIs to a beneficiaries over the phone.  Beneficiaries can usually get most of their health plan services with their plan IDs, so they shouldn’t need their MBIs.

Plans should always confirm they have the right address on file for beneficiaries and tell them to make sure that the Social Security Administration has their correct mailing address.

If beneficiaries call to ask for their MBIs because they haven’t gotten theirs yet, plans should let them know that they should contact Medicare.

Use MBIs on standardized materials

The HICN was used on many standardized forms and letters. We’ve been revising these materials just for MBI use, but until they're ready, plans should keeping using the forms they have with either the HICN or MBI as appropriate.

Share MBIs with downstream partners

Plans can share MBIs with downstream partners for Medicare-related business (payments, treatment and healthcare operations) like they share HICNs today. Plans should make sure MBIs are secure and use the HIPAA “Minimum Necessary” guidelines.

Keep HICN/MBI crosswalk records

Plans should keep records as required by existing federal and state regulations.

Where can plans get more information about MBIs?

To learn more, you can:

• Read our frequently asked questions (PDF).
• Get our past Open Door Forum training materials
  • For Coordination of Benefits Agreement (COBA) trading partners and their associates (ZIP) (1/11/17)
  • For Medicare Secondary Payer (MSP) stakeholders and processes (ZIP) (1/11/17)
• Log in to HPMS to read about MBIs for Medicare Advantage and Part D plans.
• Get updates for RDS plan sponsors and vendors. 
• You can also check our Outreach & education page for resources about getting and using the MBI.
• Find Drug Data Processing System and Payment Reconciliation System information.
• Find Medicare managed care and Medicare prescription drug enrollment guidance information.
• Get the CY 2018 call letter (PDF) to help plans prepare their bids.

Plans will get keep getting information about MBIs the same way we usually send them information about other topics, such as the Health Plan Management System (HPMS), the RDS Program website, RDS program correspondence, Medicare Advantage Prescription Drug (MAPD) Release Letters, and updates to the Plan Communications Users Guide.

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