The MBR reply on the D4 Medicare Number reflects the separate payment status by having
LAF code other than AD (LAF code will probably be C) and shows full HI/SMI entitlement
The instances of finding the B Medicare Number as the active number are diminishing.
Present policy is to make the D4 the active Medicare Number in all cases. Prior to
this policy decision, however, HI/SMI entitlement was awarded on either the B or D4
depending on the payment of benefits.
If the beneficiary has a Medicare card under both the D4 and B Medicare Numbers, the
Medicare card under the inactive Medicare Number should be recovered in accordance
with HI 00901.185. The query reply on the inactive SSN, determined from the MBR reply as described
above, should have a cross-referenced (XCN) followed by the active number. If the
health insurance master reply shows that the B and D4 Medicare Numbers are not properly
cross-referred, refer the problem to CMS.