Medicare/HICN Claim Numbers Explained

Health Insurance Claim Number (HICN)—This is the number used by Social Security and Medicare to identify a beneficiary. Social Security is responsible for all eligibility assignment and enrollment into Medicare while Medicare is responsible for oversight and fulfillment of the health benefits. The HICN may look similar to a beneficiary’s social security number, or that of their spouse or parent or child. This number shows the relationship of the recipient to that of the qualifying individual. For a beneficiary qualifying under their own work history status, the HICN will show their SSN and have a suffix of the letter “A”. For a spouse, it will have a suffix letter “B” and for a child it will have a suffix letter of “C”. Both spousal and child benefits could be provided to more than one recipient so in that case the suffix letter will be followed by a number such as: (B2) or (C3). There are more than 30 different letters that could be used for various reasons. A new recipient may have a “T” until his benefit is activated at the initial enrollment. When completing an enrollment form, always list the number as it is shown on the Medicare ID card even if you know the number will be changing. SSA and Medicare will apply the correction when the application is processed.

One example of a HICN might be: xxx-xx-xxxx-B6. This number indicates a divorced woman older than 62 is receiving benefits based upon her former husband’s work history. Another example is for Railroad Retirees, who will have a prefix instead: WA-xxx-xx-xxxx. This is because the railroad had established a similar retirement nomenclature system prior to the creation of Medicare.

Here is a an explanation of suffixes and prefixes:

A

Primary Claimant (wage earner)

B

Spouse (spouse of retired worker)

B1

Aged Husband, age 62 or over

B2

Young Wife, with a child in her care

B3

Aged Wife, age 62 or over, second claimant

B5

Young Wife, with a child in her care, second claimant

B6

Divorced Wife, age 62 or over

BY

Young Husband, with a child in his care

C1-C9

Child (includes minor, student, or disabled child)

D

Aged Widow age 60 or over

D1

Aged Widower, age 60 or over

D2

Aged Widow (2nd claimant)

D3

Aged Widower (2nd claimant)

D6

Surviving Divorced Wife, age 60 or over

E

Widowed Mother

E1

Surviving Divorced Mother

E4

Widowed Father

E5

Surviving Divorced Father

F1

Parent (father)

F2

Parent (mother)

F3

Stepfather

F4

Stepmother

F5

Adopting Father

F6

Adopting Mother

HA

Disabled Claimant

HB

Aged Wife of Disabled Claimant, age 62 or over

HC

Child of Disabled Claimant

M

Uninsured – Premium Health Insurance Benefits

M1

Uninsured – Qualified For (but refused health insurance benefits – Part A)

T

Uninsured – Entitled to HIB (part A) under deemed or renal provisions; or fully insured who have elected entitlement only to HIB

TA

Medicare Qualified Government Employment (MQGE)

TB MQGE

Aged Spouse

W

Disabled Widow

W1

Disabled Widower

W6

Disabled Surviving Divorced Wife

WA

Railroad Retirement