MEDICARE HICN NUMBER SUFFIXES Full List

Health Insurance Claims Numbers (HICNs)

All HICNs issued by SSA are 9-digit numbers with at least one letter suffix (called a beneficiary identification code or BIC) in the tenth position. If there is an eleventh position, it may be either a letter or number e.g. 123-45-6789A or 987-65-4321D4. The HICN issued by the RRB, may contain either 6 or 9 digit numbers with up to a 3-position letter prefix e.g., A123456 or MA123-45-6789. If a beneficiary's entitlement changes, it is possible for the 9-digit number, the prefix, the suffix or all three to change. It is also possible to go from an SSA issued HICN to a RRB HICN or vise versa. The numeric portion of a 9-digit HICN consists of a Social Security Number (SSN). If the BIC is A, T, TA, M, M1, J1, J2, J3, J4 or the RRB prefix is A or H the number is the beneficiary's own SSN. If the BIC or RRB prefix is other than one of the above, the SSN belongs to a number holder and the beneficiary is entitled as an auxiliary or survivor on that SSN.

Currently, the first three digits of the HICN range from 001-772. However this may change as SSA issues more numbers. All numbers except 00 are possible for the fourth and fifth digits and all numbers except 0000 are possible for the last four digits. The patient's HICN is on his/her HI card, SSA award letter, SSA Benefit Verification letter, an SSA issued Temporary Notice of Eligibility, Explanation of Medicare Benefits (EOMB), Notice of Utilization (NOU), or Medicare Summary Notice (MSN). Where the patient cannot furnish a HICN, it may be an indication that he/she has not filed an application with SSA to establish entitlement to health insurance benefits, or that SSA action on a pending application has not been completed. You Could find the full list here.


Health Insurance Claim (HIC) Numbers

HIC Accuracy – Your carrier receives numerous claims that are submitted with invalid or incorrect HIC numbers. These claims require manual intervention and can sometimes result in beneficiaries receiving incorrect EOMB information. Please be certain the HIC number you are keying is entered correctly, and is also the HIC that belongs to the patient (based on what is on his/her Medicare card) for which you are billing.

HIC Format - A correct HIC number consists of 9 numbers immediately followed by an alpha suffix. Take special care when entering the HIC number for members of the same family who are Medicare beneficiaries. A husband and wife may have a HIC number that share the same Social Security numerics. However, every individual has their own alpha suffix at the end of the HIC number. In order to ensure proper claim payment, it is essential that the correct alpha suffix is appended to each HIC. No hyphens or dashes should be used. "Railroad Retirees" - Railroad Retirement Board (RRB) HIC numbers generally have two alpha characters as a prefix to the number. These claims should be billed to the RRB carrier, at this address:

Palmetto Government Benefit Administrators
Railroad Medicare Services
PO Box 10066

Augusta, GA 30999-0001 


HIC Suffix   Sex   Explanation

A    M or F Primary Claimant
B    F  Aged Wife, Age 62 or Over (First Claimant)
B1  M Aged Husband, Age 62 or Over (First Claimant)
B2   F Young Wife, With a Child in Her Care (First Claimant)
B3   F  Aged Wife (Second Claimant)
B4  M   Aged Husband (Second Claimant)
B5  F  Young Wife (Second Claimant)
B6  F  Divorced Wife, Age 62 or Over (First Claimant)
B7   F  Young Wife (Third Claimant)
B8  F  Aged Wife (Third Claimant)
B9  F  Divorced Wife (Second Claimant)
BA F Aged Wife (Fourth Claimant)
BD F Aged Wife (Fifth Claimant)
BG M Aged Husband (Third Claimant)
BH M Aged Husband (Fourth Claimant)
BJ M Aged Husband (Fifth Claimant)
BK F Young Wife (Fourth Claimant)
BL F Young Wife (Fifth Claimant)
BN F Divorced Wife (Third Claimant)
BP F Divorced Wife ((Fourth Claimant)
BQ F Divorced Wife (Fifth Claimant)
BR M Divorced Husband (First Claimant)
BT M Divorced Husband (Second Claimant)
BW M Young Husband (Second Claimant)
BY M Young Husband (First Claimant)
C1-C9, CA-CZ M or F Child (Includes Minor, Student or Disabled Child)
D F Aged Widow, 60 or Over (First Claimant)
D1  M Aged Widower, 60 or Over (First Claimant)
D2 F Aged Widow (Second Claimant)
D3 M Aged Widower (Second Claimant)
D4 F Widow (Remarried after Attainment of Age 60) (First Claimant)
D5 M Widower (Remarried after Attainment of Age 60) (First Claimant)
D6 F Surviving Divorced Wife, Age 60 or Over (First Claimant)
D7 F Surviving Divorced Wife (Second Claimant)
D8 F Aged Widow (Third Claimant)
D9 F Remarried Widow (Second Claimant)
DA F Remarried Widow (Third Claimant)
DC M Surviving Divorced Husband (First Claimant)
DD F Aged Widow (Fourth Claimant)
DG F Aged Widow (Fifth Claimant)
DH M Aged Widower (Third Claimant)
DJ M Aged Widower (Fourth Claimant))
DK M Aged Widower ((Fifth Claimant)
DL F Remarried Widow (Fourth Claimant)
DM M Surviving Divorced Husband (Second Claimant)
DN F Remarried Widow (Fifth Claimant)
DP M Remarried Widower (Second Claimant)
DQ M Remarried Widower (Third Claimant)
DR M Remarried Widower (Fourth Claimant)
DS M Surviving Divorced Husband (Third Claimant)
DT M Remarried Widower (Fifth Claimant)
DV F Surviving Divorced Wife (Third Claimant)
DW F Surviving Divorced Wife (Fourth Claimant)
DX M Surviving Divorced Husband (Fourth Claimant)
DY F Surviving Divorced Wife (Fifth Claimant)
DZ M Surviving Divorced Husband (Fifth Claimant)
E F Mother (Widow) (First Claimant)
E1 F Surviving Divorced Mother (First Claimant)
E2 F Mother (Widow) (Second Claimant)
E3 F Surviving Divorced Mother (Second Claimant)
E4 M Father (Widower) (First Claimant)
E5 M Surviving Divorced Father (Widower) (First Claimant)
E6 M Father (Widower) (Second Claimant)
E7 F Mother (Widow) (Third Claimant)
E8 F Mother (Widow) (Fourth Claimant)
E9 M Surviving Divorced Father (Widower) (Second Claimant)
EA F Mother (Widow) (Fifth Claimant)
EB F Surviving Divorced Mother (Third Claimant)
EC F Surviving Divorced Mother (Fourth Claimant)
ED F Surviving Divorced Mother (Fifth Claimant)
EF M Father (Widower) (Third Claimant)
EG  M Father (Widower) (Fourth Claimant)
EH M Father (Widower) (Fifth Claimant)
EJ M Surviving Divorced Father (Third Claimant)
EK M Surviving Divorced Father (Fourth Claimant)
EM M Surviving Divorced Father (Fifth Claimant)
F1 M Father
F2 F Mother
F3 M  Stepfather
F4 F Stepmother
F5 M Adopting Father
F6 F Adopting Mother
F7 M Second Alleged Father
F8 F Second Alleged Mother
J1 M or F Primary Prouty Entitled to HIB (Less than 3 Q.C.) (Genteral Fund)
J2 M or F Primary Prouty Entitled to HIB (Over 2 Q.C.) (RSI Trust Fund)
J3 M or F Primary Prouty Not Entitled to HIB (Less than 3 Q.C.) (Genteral Fund)
J4 M or F Primary Prouty Not Entitled to HIB (Over 2 Q.C.) (RSI Trust Fund)
K1 F Primary Prouty Entitled to HIB (Less than 3 Q.C.) (Genteral Fund) (First Claimant)
K2 F Primary Prouty Entitled to HIB (Over 2 Q.C.) (RSI Trust Fund) (First Claimant)
K3 F Primary Prouty Not Entitled to HIB (Less than 3 Q.C.) (Genteral Fund) (First Claimant)
K4 F Primary Prouty Not Entitled to HIB (Over 2 Q.C.) (RSI Trust Fund) (First Claimant)
K5 F Primary Prouty Entitled to HIB (Less than 3 Q.C.) (Genteral Fund) (Second Claimant)
K6 F Primary Prouty Entitled to HIB (Over 2 Q.C.) (RSI Trust Fund) (Second Claimant)
K7 F Primary Prouty Not Entitled to HIB (Less than 3 Q.C.) (Genteral Fund) (Second Claimant)
K8 F Primary Prouty Not Entitled to HIB (Over 2 Q.C.) (RSI Trust Fund) (Second Claimant)
K9 F Primary Prouty Entitled to HIB (Less than 3 Q.C.) (Genteral Fund) (Third Claimant)
KA F Primary Prouty Entitled to HIB (Over 2 Q.C.) (RSI Trust Fund) (Third Claimant)
KB F Primary Prouty Not Entitled to HIB (Less than 3 Q.C.) (Genteral Fund) (Third Claimant)
KC F Primary Prouty Not Entitled to HIB (Over 2 Q.C.) (RSI Trust Fund) (Third Claimant)
KD F Primary Prouty Entitled to HIB (Less than 3 Q.C.) (Genteral Fund) (Fourth Claimant)
KE F Primary Prouty Entitled to HIB (Over2 Q.C (Fourth Claimant)
KF F Primary Prouty Not Entitled to HIB (Less than 3 Q.C.) (Fourth Claimant)
KG F Primary Prouty Not Entitled to HIB (Over 2 Q.C.) (Fourth Claimant)
KH F Primary Prouty Entitled to HIB (Less than 3 Q.C.) (Fifth Claimant)
KJ F Primary Prouty Entitled to HIB (Over 2 Q.C.) (Fifth Claimant)
KL F Primary Prouty Not Entitled to HIB (Less than 3 Q.C.) (Fifth Claimant)
KM F Primary Prouty Not Entitled to HIB (Over 2 Q.C.) (Fifth Claimant)
T M or F Uninsured-Entitled to HIB Under Deemed or Renal Provisions
TA M or F MQGE (Primary Claimant)
TB M or F MQGE Aged Spouse (First Claimant)
TC  M or F MQGE Disabled Adult Child (First Claimant)
TD M or F MQGE Aged Widow(er) (First Claimant)
TE M or F MQGE Young Widow(er) (First Claimant)
TF M MQGE Parent (MALE)
TG M or F MQGE Aged Spouse (Second Claimant)
TH M or F MQGE Aged Spouse (Third Claimant)
TJ M or F MQGE Aged Spouse (Fourth Claimant)
TK M or F MQGE Aged Spouse (Fifth Claimant)
TL M or F MQGE Aged Widow(er) (Second Claimant)
TM M or F MQGE Aged Widow(er) (Third Claimant)
TN M or F MQGE Aged Widow(er) (Fourth Claimant)
TP M or F MQGE Aged Widow(er) (Fifth Claimant)
TQ F MQGE Parent (Female)
TR M or F MQGE Young Widow(er) (Second Claimant)
TS M or F MQGE Young Widow(er) (Third Claimant)
TT M or F MQGE Young Widow(er) (Fourth Claimant)
TU M or F MQGE Young Widow(er) (Fifth Claimant)
TV  M or F MQGE Disabled Widow(er) (Fifth Claimant)
TW M or F MQGE Disabled Widow(er) (First Claimant)
TX  M or F MQGE Disabled Widow(er) (Second Claimant)
TY M or F MQGE Disabled Widow(er) (Third Claimant)
TZ M or F MQGE Disabled Widow(er) (Fourth Claimant)
T2-T9 M or F Disabled Child (Second to Ninth Claimant)
W F Disabled Widow, Age 50 or Over (First Claimant)
W1 M Disabled Widower, Age 50 or Over (First Claimant)
W2 F Disabled Widow (Second Claimant)
W3 M Disabled Widower (Second Claimant)
W4 F Disabled Widow (Third Claimant)
W5 M Disabled Widower (Third Claimant)
W6 F Disabled Surviving Divorced Wife (First Claimant)
W7 F Disabled Surviving Divorced Wife (Second Claimant)
W8 F Disabled Surviving Divorced Wife (Third Claimant)
W9 F Disabled Widow (Fourth Claimant)
WB  M Disabled Widower (Fourth Claimant)
WC F Disabled Surviving Divorced Wife (Fourth Claimant)
WF F Disabled Widow (Fifth Claimant)
WG M Disabled Widower (Fifth Claimant)
WJ F Disabled Surviving Divorced Wife (Fifth Claimant)
WR M Disabled Surviving Divorced Husband (First Claimant)
WT M Disabled Surviving Divorced Husband (Second Claimant)


Effective for cards issued in or after September 1990, HCFA is revising the appearance and composition of Medicare Cards.

The new cards are plastic, not paper. The new cards will show “Part A” immediately following “Hospital” and “Part B” immediately following “Medical”. Beginning in spring, 1991, the word “Medicare” is added in two places on the front of the card. Paper Medicare cards issued before the changeover to the new cards are still valid.

SUFFIX                       DESCRIPTION

A                                 Retired worker over 65 or disabled worker
                
B                                  Wife (over 65) of retired or disabled worker

B1                                Husband of retired or disabled worker

B2                                Wife whose entitlement is dependent on the care of a child

B3                                Second wife

B4                                Second husband

B5                                Second wife (entitlement dependent on a child)

B6                                Ex-wife (entitlement dependent on a child)

B7                                Third wife (entitlement dependent on a child)

B8                                Third wife

B9                                Third husband

C                                 Child (including a disabled child or a student). Suffixes assigned by age, i.e.:

C1                               Youngest Child

C2                               Next youngest child

C?                                Etc.

D                                 Widow


D1                               Widower

D2                               Second Widow
           
D3                               Second Widower

D4                               Widow who remarried after age 60

D5                               Widower who remarried after age 62

D6                               Surviving ex-wife

D7                               Second surviving ex-wife

E                                  Widowed mother

E1                                Mother (ex-wife) who survives the retired worker

E2                                Second widowed mother

E3                                Second mother (ex-wife) who survives the retired worker

F                                  Parent category (the F suffix is never used alone) for aged dependents

F1                                Father

F2                                Mother

F3                                Stepfather

F4                                Stepmother

F5                                Adoptive father

F6                                Adoptive mother

F7                               Second “alleged” father

F8                                Second “alleged” mother

J & K                           Special beneficiaries whose entitlement depends on the quarters of employment that they have under social security.

J1, J2, K1, K2              Entitled to Part A.
J3, J4, K3, K4              Not entitled to Part A, may purchase Part A.

M                                 An individual enrolled in Part B who is not entitled to retirement and survivor’s or Railroad Retirement insurance and is not eligible for Part A but may purchase Part A coverage.

M1                               An individual enrolled in Part B who meets the requirements for Part A but has not applied.

T                                  An individual entitled to Part A benefits but not to retirement and survivor’s or Railroad Retirement insurance or who is entitled to Medicare based on chronic renal disease. It applies whether or not the beneficiary elects to receive Part B.
              
               W                                Disabled widow

W1                              Disabled widower
              
W2                              Second disabled widow

W3                              Second disabled widower

W6                              Disabled surviving ex-wife

             W7                              Second disabled surviving ex-wife


Medicare beneficiary numbers are changing in 2018

The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015, requires CMS to remove Social Security Numbers (SSNs) from all Medicare cards by April 2019. A new Medicare Beneficiary Identifier (MBI) will replace the SSN-based Medicare number on new Medicare cards starting in 2018 for Medicare transactions like billing, eligibility status, and claim status. Find more details here.

Q: How do I obtain beneficiary eligibility information and/or claim status?

A: To access the status of a claim or a beneficiary's Medicare eligibility information (including the date of birth, date of death, entitlement dates, benefit dates, deductible, or coinsurance) use these options below.
Prior to providing services, obtain a copy of the beneficiary's Medicare card and verify the beneficiary's insurance information with either the beneficiary or his/her legal representative.
Eligibility information through SPOT
First Coast Service Options Inc. offers such access through SPOT (Secure Provider Online Tool). With SPOT, providers may access Part A and Part B eligibility status as well as benefit eligibility for preventive services, deductibles, therapy caps, inpatient, hospice and home health, Medicare secondary payer (MSP), plan coverage data categories and claim status up to twelve months from the date of the inquiry.
Other options for determining beneficiary eligibility
Part A providers
• Contact the Part A interactive voice response (IVR) system at 877-602-8816.
• Direct data entry (DDE) pdf file users -- by using the ELGA (eligibility A) screen, you can obtain eligibility information on any beneficiary for whom you are submitting claims.
• 270/271 eligibility transactions external link -- this is also a real time inquiry, and you can obtain the eligibility information in a batch format for a number of beneficiaries.
Part B providers
• Contact the Part B IVR at 877-847-4992.
Note: Customer service representatives cannot assist you with eligibility information and are required, by the Centers for Medicare & Medicaid Services (CMS), to refer you to the IVR. The IVR can access information up to 27 months from the date of the inquiry.


Medicare Advantage plan FAQ


Q: How do I determine if a patient is enrolled in a Medicare Advantage (MA) plan?

A: It is recommended you obtain eligibility and benefit information prior to rendering services to patients. Click here for ways to verify eligibility. You can also do the following:
• Ask patients if they have recently enrolled in any new health insurance plans.
• Request to see a copy of all of their health insurance cards.

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