Q: I just got my Medicare card in the mail, but the letter on the end is different than my husband’s. Is this the way it should be?

A: Everyone who has Medicare has a claim number, or a health insurance claim number (HICN). This is your ID number that is used to process all the claims and issues regarding your insurance in the Medicare system.

Very often when individuals get this card they compare it to others, spouses, friends or family to see how they differ. The ID number is composed of two individual factors, the first is whose work history you are collecting benefits under, and the second is your relationship to that person.

Everyone on Medicare is required to have so much time vested in the system to get Medicare at no premium or partial premium. So for example, Medicare Part A for most Americans comes premium free. If you pay a premium for Part A it could cost up to $426 per month. If you have a 10-year work history, that premium is paid for you. If you are somewhere between no work history and a 10-year work history, it is a sliding-scale premium. If you didn’t work or worked less than 10 years, you may be able to collect your Medicare benefits under the work history of your spouse or a past spouse. Some can even collect on behalf of a parent, but I will focus on those cases over 65.

So we have determined that you are collecting on your work history, so the ID number is your number and the letter after that is usually “A” or “T.” The letter “A” means that your are collecting Social Security. The letter ‘T’ means that you have not yet filed for Social Security benefits; you are not receiving any money from Social Security. Once you begin collecting Social Security benefits, you will receive a new card in the mail with the letter “A” at the end.

If you are receiving your Medicare benefits on the work history of someone else, there are lots of letters that will be at the end. I will cover the most common. The letter “B” will mean you are collecting benefits under the work history of your current spouse and the number will be their ID number as well. The letter “D” means you are collecting benefits under the work history of a deceased spouse. Sometimes these two letters could be followed by a number (B6 or D2), that means there are multiple people collecting on that work history (the individual was married more than once).

If your Medicare HICN is an ID number with the letter “B” at the end and your spouse dies, you will be sent a new Medicare card. The new Medicare HICN will be the same number with the letter “D” after it.

Another time the Medicare number may change is when you switch whose work history you are collecting Social Security benefits under. An example is you begin to collect Social Security at 62 under your spouse’s work history. When you turn 65 your Medicare HICN will be their ID number and a “B” at the end. Then when you turn 70 you go back to Social Security and discover that your work history has continued to accrue benefits and that collecting under that work history your benefits will increase. Your Medicare HICN will also change. It will switch to your ID number and the letter “A.”

For individuals collecting benefits under the Railroad Retirement system, they have a whole different series of letters and numbers. That is much less common.

When you receive your Medicare card be sure to show it to your physicians and providers. If you get a new card with a new number be sure to show this to them as well. This sharing of information will help to process your claims in a timely manner.

To contact Janell Sluga, GCMC with questions or concerns, please call 720-9797 or email her at janells@lutheran-jamestown.org.