MACRA hidden impacts – removal of SSN from Medicare cards

Like many major healthcare laws (Accountable Care Act, anyone?), the Medicare and CHIP reauthorization Act (MACRA) has myriad impacts. One significant component of MACRA is the removal of Social Security Numbers (SSN) from Medicare cards. Medicare will begin issuing new beneficiary cards with the Medicare Beneficiary Identifier (MBI) replacing the beneficiary’s SSN in April 2018, with the change fully implemented by April 2019.

The intention behind the change is altruistic – CMS is seeking to lessen the risk of identifying theft and the financial, medical, and quality-of-life havoc that can wreak for Medicare beneficiaries. But of course, as with even the most well-intentioned changes, this one brings with it challenges given the sheer scale of the change and the number of beneficiaries and providers impacted.

Let’s take a look at exactly what’s changing, how the change is being managed, and how organizations like the Cooperative Exchange can help ensure your voice is heard as you and your Medicare patients manage the transition.

New Medicare cards without SSN will be sent out beginning April 2018

The first aspect to be aware of is that CMS will begin sending out new cards in April 2018. A couple key things to keep in mind:

  • Providers can play an important role in making their Medicare patients aware that CMS will be sending out new cards. This will help ensure Medicare beneficiaries (and their families) know to be on the lookout for the cards.
  • Similarly, providers can coach beneficiaries and their families to be aware of the importance of the MBI, both in terms of the need to have it available once they receive the new card, and the importance of protecting it as it will be the primary identifier for all Medicare patients after April 2019.

What’s the deal with the MBI?

Per CMS, MBI will be:

  • Clearly different than the Healthcare Insurance Claim Number (HICN) and Railroad Retirement Beneficiaries (RRB) number
  • 11 characters in length
  • Made up only of numbers and uppercase letters (no special characters)


It’s important for beneficiaries and medical staff to know what the new cards will look like so that they can spot at a glance whether the MBI is legitimate. This will save time and rework – if a Medicare patient provides an MBI that only contains 10 characters, for example, or that contains a hyphen rather than an 11th character, staff will know they need to reconfirm this number with the patient.

Second, and equally important, providers need to talk to their vendors to ensure all software and systems are updated ahead of the changeover to MBIs, and able to accept the MBI in place of the SSN.

What feedback has been provided to CMS regarding this change? Where can I learn more?

To learn more, check out this presentation created by the Cooperative Exchange.  For more information regarding the shift, and to stay up-to-date about the change, visit CMS’ page about the Social Security Number Removal Initiative here.

About the author: Crystal Ewing is the Manager of Data Integrity for ZirMed and Board member of the Cooperative Exchange.  Crystal is an active participant in the Cooperative Exchange Emerging Trends Workgroup; a workgroup working through the SSNRI issues.