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What Is a Medicare Card?

What Is a Medicare Card?

Maybe you thought you were done collecting cards—baseball cards, credit cards, Pokémon cards—juvenile stuff! Well there’s one more collection you’ll probably have to put together: Medicare cards!

What is a Medicare card? Well, you’ll need it to prove you have Medicare whenever you visit the doctor for one of those fun colonoscopies or whatever medical treat you’re in for. We can hear your enthusiastic cheering through the screen. Yes, it’s exciting, we know, but there are a few things you’ll need to understand before you run out and start grabbing as many as you can.

Medicare is a complex program with different parts and options, and you’ll want to get some advice on it first. Once you’ve nailed down which plans are right for you and signed up, then you’ll need to carry up to three of these cards.

Yes, three. You might want to consider getting a bigger wallet.

 

What Is a Medicare Card?

Your Medicare card proves that you have Medicare coverage. It also shows your unique Medicare number, what kind of coverage you have, and when that coverage started. When you go to a provider for a service—say your doctor’s office for a colonoscopy—you show them your Medicare card so they can bill Medicare.

Different Types of Medicare Cards

Like we said, there are a few Medicare cards and they’re not all the same. Each one represents a different part of Medicare.

Original Medicare Card: This red, white and blue card represents Parts A and B if you’re enrolled in Original Medicare. Show this card at hospitals and medical appointments.

Medicare Prescription Drug Coverage Card: If you have Part D, you should carry this card and present it whenever you go to the pharmacy to pay for your drugs.

Medicare Advantage Card: If you have Medicare Part C, aka Medicare Advantage, you’ll have just one card for all your parts of Medicare. So you’ll use this at the hospital, doctor and pharmacy.

Medigap Card: Technically this one doesn’t fall under the traditional “Medicare card,” but we’re lumping it in because if you have Original Medicare and a Medicare Supplement Plan, this is part of your coverage. You’ll show this whenever you show your Original Medicare card. Providers use the info on this card to bill your Medigap Plan provider to cover your out-of-pocket costs.

 

How to Obtain a Medicare Card

Not just anyone can get a Medicare card (it’s an exclusive club, you know).

Eligibility Requirements

You can get a Medicare card by:

  • Turning 65 and signing up for Medicare
  • Being disabled
  • Developing ALS (Lou Gehrig’s disease)
  • Having end-stage renal disease (you need dialysis)

Okay, so those last three are not great. In fact, we’re willing to bet that if that’s you, you’d be delighted to not qualify for a Medicare card. But if that is you, you can get Medicare (and a card) to help pay for your medical expenses.

Application Process

So, the application process for a Medicare card is actually just signing up for Medicare! Your new Medicare card will come automatically once you’re enrolled.

If you’ve already been receiving Social Security payments (for at least four months before your 65th birthday), you’ll automatically be enrolled in Medicare when you turn 65 (Parts A and B). If you’ve put off taking Social Security payments though, you’ll need to enroll yourself in Medicare during your initial enrollment period when you turn 65.

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If you fall into one of the middle two categories in our list above and you’ve been receiving Social Security Disability for 24 months, you’ll also be automatically enrolled in Medicare at the beginning of your 25th month. If you have end-stage renal disease, you can sign up by calling Social Security or visiting your local Social Security office.[1]

It should take about two weeks to receive your Medicare card in the mail once you’ve signed up. If your card doesn’t show up, try checking the delivery tracker map in your Medicare account to see where it is. If the map shows it arrived but you never got it, call 1-800-MEDICARE. Your Medicare account also has a way to print an official copy of your card (or just see your number).

 

Understanding Your Medicare Card

We know you were probably hoping for a picture of a cool bottle of medicine or ambulance on your card. It’s a bummer, but it’s mostly just numbers, letters and more numbers. However, depending on the Medicare plan you have, your card will look a little different.

Original Medicare Card

Your Original Medicare card has a blue banner at the top and there’s a cool little eagle drawn in line art in the left corner (hey, that’s something).

Here’s the key information on the card:

  • Your name
  • Your Medicare number
  • Your coverage details

Each of the important bits of information on the card are labeled. At the top, you’ll see Medicare Health Insurance. Below that to the left is your name. Next, you’ll find your Medicare number. This is the number your health care provider will need to bill Medicare.

At the bottom, the card states what parts of Medicare you have and when your coverage started. If you have Original Medicare, it will say Hospital (Part A) followed by the date you got it, then Medical (Part B) followed by the date you got that (often the same date). This means you have coverage for hospital visits (Part A) and coverage for other medical visits like the doctor or outpatient services (Part B).

While your Medicare card no longer has your Social Security number on it, your Medicare number is still sensitive data, and you need to keep it safe. Treat this card like your debit card and don’t leave it out anywhere.

Medicare Advantage Card

Unlike Original Medicare, Medicare Advantage comes from a private insurance company. This card works for all your different coverages, including Parts A, B and D. You’ll show it to your provider when you receive Medicare-approved services like say . . . that colonoscopy.

If you have Medicare Advantage, your card will look different depending on who your insurance provider is.

Here’s a list of info these cards often have:

  • Your name
  • Your ID number
  • Your plan and plan number
  • The date your plan benefits started
  • Your prescription drug coverage info

Heads up: You will still have a regular red, white and blue Medicare card even if you have Medicare Advantage. But you won’t present it to your medical provider—you only use your Medicare Advantage card. Keep your red, white and blue card in a safe place. You’ll need it if you ever switch to Original Medicare.

Medigap Card

If you have Original Medicare, odds are you’ll have Medicare Supplement Insurance too (Medigap). You’ll get another card with this plan (yay!). Like Medicare Advantage, Medigap is offered through private health insurance companies so each card will look a little different.

Key info on the card:

  • Your name
  • Your policy or ID number
  • The date your plan benefits started
  • The name of your plan (for example, Plan G)

Like with the other cards, your Medigap card contains sensitive data so make sure you keep it secure.

Part D Card

We’ve got one more card to get through. This one’s for your prescription drug coverage called Part D. Even though this is part of federally run Medicare, you actually get your plan through a private insurer contracting with the federal government. Know what that means? You guessed it—your card will look different based on who you get your plan through.

Key info on your Part D card:

  • Your name
  • Your ID number
  • Rx Bin (Bank Identification Number): This helps pharmacies figure out which insurance company to bill
  • Rx PCN (Processor Control Number): A unique number that helps pharmacies identify patients
  • Rx GRP (Group): This indicates what employer (if any) you have your plan through

Like with all the others, keep this card secure.

 

Using Your Medicare Card

Unlike Pokémon and baseball cards, your Medicare cards are actually useful! You need to bring them with you whenever you visit a provider. In fact, it’s best to carry them with you whenever you leave the house, because if you end up in an accident and need to be taken to the hospital, it will be helpful (we hope that never happens).

Here’s when you will need to use your card(s):

  • At medical appointments
  • For hospital stays
  • For prescription medications
  • To buy durable medical equipment (DME)

All you need to do is show your card to the provider and they’ll get the info they need to bill Medicare. If for some reason you forget your Medicare card at home, you can always log into your Medicare account, find the “Print my card” tab, and either print it off or just show it to them on your phone.

Making Sure Your Coverage Is Applied Correctly

At this point it’s pretty obvious: Medicare is complicated. And the billing process is right up there with the rest of it. Sometimes you can get double-billed for the same service (especially if you saw multiple providers). Sometimes you may have questions about whether your coverage was applied correctly. It’s a good idea to double-check your billing if you have any thought that something’s not right.

You can check your billing by:

  • Asking your provider for a copy of your medical records and comparing that to your bill
  • Contacting your providers’ billing departments (Ask for a detailed bill, and if you think you were double billed, compare bills from each provider.)
  • Comparing the billing codes on your bill with the care you got by looking them up online (The billing code for a colonoscopy is CPT code 45378.)
  • Get help from a Medicare advocate

 

Medicare Tips That Set You Up for Success

Government programs are the best . . . at being confusing. And Medicare is no exception. But you can download a guide that makes learning the basics of Medicare feel like talking to a no-nonsense friend over coffee.

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What to Do About a Lost or Stolen Medicare Card

Life happens. Sometimes we lose things or worse, people lift our wallets when we’re not looking. If this happens to your Medicare card, there are a few things you should do.

First, get a new one. You can order or print a replacement card in your medicare.gov account or call 1-800-MEDICARE. If you lost your Medicare Advantage or Medigap card, contact the private insurer you got your plan through for a replacement.

It’s a good idea to keep copies of your insurance cards in a safe place in case you lose one and need it before you can get a replacement. You should also watch out for Medicare fraud. Older folks are some of the biggest targets of fraud. So keep an eye on your Medicare Summary Notices (MSN) for any services listed that you didn’t receive.

 

Get Help From Licensed Advisors

Next, we have a few large wallet recommendations for you. Not really. But we do have a recommendation for how to get help wading through the confusion that is Medicare: Talk to a licensed advisor from Chapter. It’s free.

These guys know their Medicare stuff and will help you find the right plan for your situation. They’ll help you figure out if you need to add a supplement plan to be fully covered while also working to save you money (they shop over 24,000 different plans!).

But they don’t stop there. After you have the right plan for you, Chapter advocates help you navigate using your benefits whenever you need a helping hand, and check in annually to make sure your plan is still working for you.

 

Next Steps

If your information is wrong (like your name is misspelled) on your Medicare card, contact the Social Security Administration to make sure your information (name, birthdate and address) on file is correct. Medicare pulls your info from them to make your card.

If this happens, it probably means your provider doesn’t accept Medicare. Ask your doctor for a referral to a different provider who does. You can also try going to an urgent care since most of those accept Medicare. Of course, you can also do your own research.

Or it could be that your provider is “non-participating,” which means they only accept Medicare on a case-by-case basis. If your provider is non-participating and they decide not to accept Medicare payment for the service you got, a few things could happen:

  • You may have to pay up front for the service at the doctor’s office when you receive the service.
  • You should make sure they submit a claim to Medicare for any services they give you that Medicare usually covers, so that you can get reimbursed through Medicare. If they won’t submit a claim, you can do it yourself using the Medicare claim form.

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