TN 8 (11-22)

HI 00901.225 Medicare Card Inquiries - Non-receipt of Medicare Card and Field Office (FO) Action

A. General

A beneficiary can expect to receive the Medicare card within 2 weeks after the SSA processes the initial claim or postentitlement enrollment request. If the Railroad Retirement Board (RRB) has jurisdiction, refer the caller to RRB at 1-877-772-5772. A Medicare Beneficiary Identifier (MBI) is assigned for all new entitlement effective April 2018. All other beneficiaries will be issued a new card with the MBI in phases, which should be completed by 5/1/2019. Beneficiaries can obtain the MBI online with an established mySocial Security account, 24 hours after SSA establishes the entitlement. Encourage beneficiaries to register for an account at mysocialsecurity. To handle non-receipt of Medicare cards for new entitlement and postentitlement cases use the following procedures.

B. Non-receipt of initial Medicare card for new entitlement cases

New entitlement cases are those where a beneficiary has recently filed for Medicare, recently became entitled to Medicare or has become re-entitled to Medicare benefits.

If a beneficiary states they did not receive the Medicare card and it is a new entitlement case, follow this procedure:

  1. 1. 

    Request an abbreviated Account Query (AACT).

  2. 2. 

    Determine whether it is time to follow up:

    • automatic enrollment and card not received by the end of the 1st month of the Initial Enrollment Period (IEP), or

    • beneficiary lives in Puerto Rico or outside the U.S. and 4 weeks elapsed since the FO input the CMS-40B enrollment form, or

    • domestic initial claim was processed more than 2 weeks ago. Are the time-frames met?

    • If yes, go to step 3.

    • If no, review all important and inform the beneficiary when they should be receiving the Medicare card. Advise the beneficiary to re-contact the FO if the card is not received by then.

  3. 3. 

    Does the AACT show Hospital Insurance (HI) and or SMI entitlement?

    • If yes, go to step 4

    • If no, send and MDW to the payment center (PC) STOP.

  4. 4. 

    Request a HI/SMI Query Response (HIQR). Does the CMS DATA show HI and or SMI entitlement?

    • If yes, go to step 5.

    • If no, MDW to the payment center (PC) to force an interface and then determine if a CMS-2178-U2 to CMS RO is appropriate, see HI 00930.005. STOP

  5. 5. 

    Press Enter on QRHI to retrieve the ADDR screen. Follow this procedure.

    If the address is ....

    Then

    correct on both SSA and CMS records

    go to step 6.

    incorrect on the Master Beneficiary Record (MBR)

    • complete the POS Address/Direct Deposit/Phone Change of Address (PEAD) screen to correct the MBR. If SSI is involved, also process the SSI change of address.

    • input Health Insurance Replacement Card (HCRQ).

    • advise the beneficiary the card should be received in 2 weeks.

    • STOP.

    correct on the MBR but incorrect on CMS records

     

    • input Health Insurance Replacement Card (HCRQ). On HCRQ, retype some part of the address (e.g., the 2-letter state code). (This will cause the system to send the correct address to CMS for the Medicare card, but it will not update CMS records.)

    • If no , send an MDW to the payment center (PC) to force an interface and then determine if a CMS-2178-U2 to CMS RO is appropriate, see HI 00930.005.

  6. 6. 

    Does the QHRI show a MEDICARE CARD ISSUED date within the last 14 days?

    • If yes, advise the beneficiary of receipt of a Medicare card is 2 weeks from date MEDICARE CARD ISSUED.

    • If no:

      • input Health Insurance Replacement Card (HCRQ)

      • advise the beneficiary the Medicare card should be received in 2 weeks

      • inform the beneficiary that SSA provides this service online and through an automated service on our National 800 Number. Encourage the caller to consider using one of these service options the for the next replacement Medicare card. Explain the advantages of the online and automated services, which allows user to submit a request quickly and without a wait to speak to an SSA representative.

C. References

  • HI 00901.085 New Entitlement Cases- Card Issuance

  • HI 00930.005 Revised Form CMS-2178US (HI/SMI Entitlement Problem Referral)


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0600901225
HI 00901.225 - Medicare Card Inquiries - Non-receipt of Medicare Card and Field Office (FO) Action - 11/01/2022
Batch run: 11/01/2022
Rev:11/01/2022