What Is A Medicare Card?
A Medicare card is a government-issued identification card for individuals enrolled in the Medicare program.
The Medicare card serves as proof of enrollment in the program and is required when seeking medical services covered by Medicare. It contains important information such as the beneficiary’s name, Medicare number, and the effective dates for Medicare Part A (hospital insurance) and Part B (medical insurance).
All Medicare-eligible adults should automatically receive a Medicare card about three months before their 65th birthday. Eligible people who qualify for Medicare because of a disability or permanent kidney failure will get their cards 22 months into receiving Social Security Disability Insurance (SSDI) or at the onset of dialysis treatment.
Your card will state your full name, your Medicare ID number, and whether you have Medicare Part A, Part B, or both coverages. Anytime you receive medical service, present your Medicare card to your provider, hospital, or primary care clinic to establish your benefits.
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How Do Medicare Cards Work?
Medicare cards prove your benefit eligibility to participating medical providers and hospitals. Securing one of these cards should prove a relatively simple and, in most cases, automatic process.
Who Gets a Medicare Card?
Anybody eligible for and enrolled in Original Medicare will get a Medicare card. The following groups qualify for Medicare Part A (Hospital Insurance) and Part B (Medical Insurance):
- Adults over 65 years old.
- People with specific disabilities.
- Individuals with End-Stage Renal Disease (ESRD).
To secure your card, you must have either signed up for Medicare through Social Security, signed up for Social Security retirement benefits, or waited until your 65th birthday for automatic Medicare enrollment. Once enrolled, you will receive a Medicare welcome packet with a statement of benefits, a booklet explaining important decisions you’ll need to make before coverage begins, and your Medicare card.
When Do You Receive Your Medicare Card?
Typically, Original Medicare coverage begins at age 65. Most people will automatically receive their card three months before this qualifying birthday. However, people with eligible disabilities or permanent kidney failure (ERSD) who have worked and paid their share of Social Security tax will qualify for a Medicare card regardless of age. Medicare coverage for individuals receiving SSDI begins after a 24-month waiting period and immediately after the first dialysis procedure for people with ERSD or ALS. In contrast, those receiving dialysis will receive their card on the first day of the fourth month of treatment.
Social Security will send you one Medicare card upon initial enrollment. If your card gets lost or damaged or you switch back to Medicare from another insurance policy, you must reorder a new card.
What Information Is Contained on a Medicare Card?
You will find your red, white, and blue Medicare card when you open your Medicare welcome packet. Printed on its face should read:
- Your government name: Your full first and last name and middle initial as registered with Social Security.
- Medicare ID number: A combination of letters and numbers that allows medical professionals to bill your Medicare account and access your benefits directly.
- Coverage details: Your card will inform healthcare providers which Original Medicare plans you have enrolled in (Part A, Part B, or both) and when coverage for each began. Keep in mind that If you get Medicare through the Railroad Retirement Board, your card will say Railroad Retirement Board at the bottom.
How Can You Use a Medicare Card?
Presenting Your Card at Healthcare Providers
Anytime you receive eligible medical services at a Medicare-approved primary care clinic, hospital, or pharmacy, that institution’s billing and reception team will need the information on your card to bill Medicare appropriately. After your first visit, healthcare providers will often make a copy of your card to keep on file for future appointments.
Billing and Claims With Your Card
Typically, Original Medicare members will not have to file claims for medical reimbursement. However, if your medical facility fails to debit Medicare or a non-participating provider bills you directly, you will have to file a Medicare claim. Your card gives you the information needed for your claims form and customer service representatives assigned to your case.
Protecting Your Card and Personal Information
Unfortunately, as with other financial services in the digital age, active members should keep alert for Medicare fraud. Protect your card like an ordinary credit card, and do not share your information with anyone outside your trusted medical network. Regularly review your Medicare summary notice for errors and report any suspicious activity or unauthorized claims.
Do You Only Get One Card for All Your Medicare Needs?
Medicare cards only provide access to your Original Medicare Part A and B benefits. If you receive supplemental Medicare benefits, you will need one or more of the following cards:
- Prescription Drug card: Allows participating pharmacies to access your Medicare drug plan (Part D).
- Medicare Supplement card: Credits beneficiaries for copays, deductibles, and coinsurance not covered by Original Medicare.
- Medicare Advantage card: If you have chosen Medicare Advantage over Original Medicare, you will use a separate Medicare Advantage card for all eligible doctor, hospital, and prescription drug services.
Because private insurers fund these policies, all these cards may visually appear differently. Original Medicare cards, conversely, all look the same.
Navigating Medicare Plans With Your Cards
To properly utilize your Medicare cards, you must understand the breadth of your Medicare coverage, how and when to switch between plans, and how to coordinate Medicare with outside insurance.
Understanding Your Medicare Plan Coverage
Medicare cards will indicate whether you have Medicare Part A, Part B, or both. Typically, after you meet your $1600 Part A deductible, Medicare Part A will fully pay for the cost of a hospital stay up to a set amount of days before charging a daily copayment. Medicare Part B will cover 80% of all eligible medical services after you meet your Part B deductible of $226.
Cost-sharing and out-of-pocket costs will vary for Medicare Advantage, Part D coverage, and Medicare supplement plans, as various insurers oversee these policies and follow separate billing practices. Call the number on the back of your card if you have any questions.
Switching Between Medicare Plans
If you switch from Original Medicare to a Medicare Advantage plan or vice versa, hold on to your old card. Open enrollment for Original Medicare falls between October 15 and December 7th each year. Once enrolled, your coverage will start on January 1st of the following year. Similarly, you can enroll in Medicare Advantage between January 1st and March 31st annually, but coverage will not begin until a month after your new insurers receive your request.
Holding on to your previous card gives you access to your old policy until the switch officially occurs. You can also reuse your initial Medicare card if you eventually change your mind and transfer back to Original Medicare.
Coordinating Medicare With Other Insurance
Some people combine Medicare with employer group insurance policies, veterans benefits, or Medicaid for more comprehensive coverage. If this applies to you, your respective insurers will team up to pay for a split percentage of care, otherwise known as coordination of benefits.
In some cases, Medicare will cover the bulk of your healthcare bill up to its coverage limit, leaving your second insurance provider to absorb the remaining eligible costs. In other cases, the opposite will apply. By presenting your Medicare card along with your Medicaid card, Veteran Health Identification Card (VHIC), or proof of employer-sponsored health benefits, the billing experts at your medical facility can appropriately coordinate your dual coverage.
How To Get a Medicare Card
After you enroll in Medicare, your card should automatically arrive in the mail shortly before coverage begins. If it never shows up or you need healthcare immediately to help with a disability, you can apply for a Medicare card online, over the phone, or in person at a Social Security office.
Medicare automatically enrolls most eligible adults at age 65 and will mail them their complimentary card. Keep in mind that Medicare coverage starts the first day of the month before you turn 65.
However, individuals under 65 with qualifying disabilities such as ALS or permanent kidney failure must apply separately and can conveniently do so through Social Security’s online account portal.
Once you confirm your eligibility and create your Social Security account, you will need to provide personal information like your birthplace and social security number, as well as evidence of when you began receiving disability benefits or dialysis. If coverage gets approved, Medicare will mail you a new ID card. Or, if you have a printer, you can bypass this waiting period by printing an official copy directly from your account page.
In rare cases, Medicare-eligible people over 65 do not receive their Medicare cards by the time they begin receiving benefits. Usually, this non-delivery will occur because of a problem with their account, like an out-of-date address. To quickly update account details or apply for a new Medicare card, first-time enrollees and current beneficiaries can call 1-800-MEDICARE. Deaf and hard-of-hearing individuals using TTY devices can dial 1-877-486-2048.
People under 65 with qualifying disabilities or ERSD can also apply over the phone by providing the same information necessary for an online application.
You can also apply for a Medicare card at your local Social Security office. Along with a handwritten application, your agent will ask you to provide documents proving your disability, dialysis treatments, or general Social Security eligibility. Some people 65 and older who did not work enough or pay Medicare tax throughout their lives will not qualify for premium-free Part A. If this proves the case, you can purchase Part A coverage for a set monthly premium.
By applying for a Medicare card in person, you can ask and answer complicated questions face-to-face with a trained agent. Even if you automatically qualify for or already receive benefits, Medicare coverage has many unique stipulations and billing nuances that could need human clarification.
Can You Replace a Lost or Stolen Card?
Yes, you can replace a lost or stolen Medicare card online through your Social Security account, over the phone, or in person at your local Social Security office. Typically, a replacement card will take around 30 days before arriving in the mail. If you need documentation before then, you can request a letter of proof mailed to your address within ten days. Or, if you have a printer at home, you can print out an official copy of your ID card from your Social Security account.
Putting It All Together
Medicare cards allow members to prove their coverage benefits anytime they receive qualified care and gives healthcare providers the information needed to bill Medicare directly. Original Medicare cards come standard issue for all members, whereas Medicare Advantage, Medicare Part D, and Medicare Supplement cards can vary in detail depending on your insurer.
While most eligible adults automatically receive their card in the mail, those who do not meet Medicare tax eligibility and younger people with qualifying disabilities will have to take additional measures. To secure your Medicare card, simply create and log into a Social Security account online or apply over the phone or in person at your local Social Security office.