TN 43 (10-21)

HI 01001.090 Receipt of Premiums in the Field Office (FO)

If the beneficiary wishes to make premium payments in the FO, the following procedures apply: (See GN 02403.000 for general processing of receipts.)

A. Procedure - initial premium payment in connection with current enrollment

If a beneficiary wants to make a payment before the Supplementary Medical Insurance (SMI) award is prepared, follow the procedure in the next section, Section B. Follow the procedure in GN 02403.007 for providing a receipt for the premium payment.

B. Procedure - payment other than initial premium payment

Payment of premiums in the FO should be discouraged for the reasons given in HI 01001.025. However, if the beneficiary offers to pay his/her premiums in the FO:

  1. 1. 

    Explain the advantages of paying their future premiums directly to the Medicare Premium Collection Center (MPCC). Payments received in the FO could delay the payment process by at least 5-7 days. Mailing the payment saves the time and expense of visiting the FO. It also helps hold down administrative costs, which affects the cost of premiums each year. Additionally, note that FOs cannot accept credit card payments in the office or over the phone. If a beneficiary received a Medicare Premium Bill (CMS-500), encourage the individual to send their payment with the payment coupon from their CMS-500 as soon as possible in order to avoid possible termination directly to:

Medicare Premium Collection Center
P.O. Box 790355
St. Louis, MO 63179-0355
  1. 2. 

    If the beneficiary insists on paying in the FO and they have their CMS-500 payment coupon, forward their payment and coupon to the Medicare Premium Collection Center at the address below.  Avoid sending additional items or correspondence other than the payment and CMS-500 coupon.  To reduce delays as much as possible, the payment needs to be sent out the same day it’s received from the beneficiary.  NOTE: The Medicare Number must be clearly shown on the check/money order.  The letters B, I, L, O, S, and Z aren’t used in Medicare Numbers because they are similar to certain numerals.

Medicare Premium Collection Center
P.O. Box 790355
ST. Louis, MO 63179-0355
  1. 3. 

    If the beneficiary doesn’t have their CMS-500 payment coupon, a manual CMS-500 coupon should be created by the FO and sent to the MPCC by close of business the same day to reduce delays as much as possible, to the address in Steps 1 and 2 above. Avoid sending additional items or correspondence other than the payment and CMS-500 coupon. NOTE: The Medicare Number must be clearly shown on the check/money order. The letters B, I, L, O, S, and Z aren’t used in Medicare Numbers because they are similar to certain numerals.

  1. 4. 

    Don’t deposit a beneficiary payment intended for Medicare premiums into Social Security’s Trust Fund.

    PLEASE NOTE: Depositing the funds into Social Security’s Trust Fund will initiate the Inter-Governmental Payment and Collection (IPAC) system process and will cause an even more significant delay.

  1. 5. 

    Inform the beneficiary that if they are in direct bill status, the fastest way to make a Medicare premium payment is through their secure Medicare.gov account. If the beneficiary has questions about their Medicare.gov account, direct them to 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-800-486-2048. NOTE: The beneficiary cannot pay through Medicare.gov if they are not in direct bill, such as LAF S9 for Part B, or if the beneficiary has been final terminated for non-payment

NOTE: If a spouse wants to remit SMI premiums for both, instruct the spouse to remit the payments separately, to ensure the payments are processed timely. Each payment should have a CMS-500 payment coupon, and there should only be one payment per person, per envelope, and the same instructions listed above in Steps 1-5 apply.

A separate receipt should be made out for each enrollee. Avoid accepting remittances in cash, however, if the beneficiary insists; follow the procedures in Section C. Procedure – Receipt of Cash.

If a payment is accepted, prepare an automated receipt (see GN 02403.030).

NOTE:The Medicare Number must be clearly shown on the check/money order.

The letters B, I, L, O, S, and Z aren’t used in Medicare Numbers because they are similar to certain numerals

Provide the beneficiary with a copy of the receipt. It is the responsibility of the FO to follow up on the premium payment if it is not shown on the direct billing record within 30 business days. Use the processing or post mark date and the amount of premium payment to verify the entry on the direct billing record, Health Insurance/Supplementary Medical Insurance Query Response (HIQR). Direct follow-up inquiries to DirectBilling@cms.hhs.gov. If no substantive response is received to the first follow-up, follow up again in 15 business days.

If the entry is on the direct billing record, no action is necessary. If the remittance is not reflected on the current HIQR, Medicare Premium Payment Query (MPPQ), develop the case as a premium problem and forward to the email address above. Attach all necessary information, including: a copy of the canceled check (back and front) showing it was endorsed for CMS Premiums Retail by the Federal Reserve Bank in Cleveland, or a copy of the beneficiary’s bank statement or credit card statement showing the payment to CMS, or if the payment was deposited by SSA – the IPAC number as proof the funds were transferred from SSA’s Trust Fund to CMS’s Trust Fund. In order to prevent duplicative remittances, a copy of the RFQD screen alone is no longer enough proof to credit a payment.

C. Procedure - receipt of cash

Cash payments should always be discouraged. However, if the beneficiary insists on a cash payment, convert it daily into a check or money order, and forward it with appropriate CMS-500 payment coupon in accordance with section HI 01001.090to the address below . Do not hold cash overnight. If the beneficiary does not provide the CMS-500 payment coupon, the FO creates a manual CMS-500 payment coupon before mailing the payment. Avoid sending additional items or correspondence other than the payment and CMS-500 payment coupon.

Since payments received in the FO could delay the payment process by at least 5-7 days, the payment needs to be sent out the same day it’s received from the beneficiary to reduce delays as much as possible.

NOTE: The Medicare Number must be clearly shown on the check/money order. The letters B,I,L,OS, and Z aren't used in Medicare Numbers because they are similar to certain numerals.

Medicare Premium Collection Center
P.O. Box 790355
St. Louis, MO 63179-0355

D. Procedure - receipt of Explanation of Medicare Benefits (EOMB) or Medicare Summary Notice with remittance for premium arrearage

All EOMBs that are received in the FO from carriers along with checks made payable to Medicare Insurance for premium arrearages should be forwarded to the Medicare Premium Collection Center for processing. This should be very rare.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0601001090
HI 01001.090 - Receipt of Premiums in the Field Office (FO) - 10/15/2021
Batch run: 10/15/2021
Rev:10/15/2021