Your Medicare Card: What does the letter after the SSN mean?

The other day a retired friend asked me what the letter means on his Medicare card. His is an “A” which appears after his social security number. It is on his Medicare card but not on his Social Security card. His wife’s Medicare card has a different letter on it – a “B”. Even more confusing, he said, his wife’s Medicare card has his social security number on it. “Why is that?” he asked.

Good Question. I had wondered about that myself when I reached age 65 and got my Medicare card. Here is the answer. 

Different Categories of Social Security Benefits

Over 1.6 million Pennsylvania retirees receive a payment from Social Security each month on their own earning record. But Social Security is much more than just a retirement program for workers. Nationally, only about 64% of beneficiaries receive their payments as retired workers. 

Another 4.2% receive benefits as non-working spouses based on the retired worker’s earnings. The remaining 32% receive benefits as disabled, survivors, or dependents. 

Social Security assigns letter codes to identify under which category a recipient is qualifying for his or her benefit. The Social Security website has a list of the most frequent codes – you can find it here.  

My friend qualified for Social Security on his own record as a wage earner. Thus the letter on his Medicare card is “A” – the most prevalent code.  His wife did not work outside the home. She qualified for social security benefits as the spouse of a retired wage earner, based on her husband’s record. Thus, her card uses the letter “B” along with the social security number of the wage earner - her husband. 

Social Security Numbers Continue to be used on Medicare Cards

While the letter codes do not appear on your Social Security card, they are used on your Medicare card. Your Medicare claim number is the social security number of the primary wage earner on which benefits are based, plus your appropriate letter code. 

Your letter code can change if your benefit category changes. For example, if you get Medicare benefits at age 65 based on your own work record but are deferring claiming your social security benefits, you will be assigned the code letter “T”: that means you are fully insured but have elected to collect only health insurance (Medicare) benefits for now. When you later do sign up to start receiving Social Security monthly payments your letter code will be changed to “A” and you will get a new Medicare card.   

A Dangerous Practice

Another good question is: why does the government keep showing social security numbers on the Medicare cards we have to carry and use so often, given the serious threat of identity theft? Unfortunately, I don’t have a good answer for that. 

I do understand that changing to a new numbering system would cost the government some money and require reissuance of over 50 million cards. But exposing Medicare beneficiaries to an increased risk of identity theft is just unacceptable. Wouldn’t it be nice if Congress required a change in this dangerous practice as part of any upcoming changes to the Medicare program?  If you agree, let your Congressional representatives know you care about this important financial protection issue. 

In the meantime, we are stuck with seeking other ways protecting our identity and privacy. Personally, I don’t carry my original Medicare card. I carry a photocopy from which I have removed the social security number.  I give my social security number verbally to the health care provider at the time I present a photocopy of the card and request services.

Not a perfect plan, I’ll admit. But, at least it may help protect me if my wallet gets lost or stolen.