Insurance ID - BOX 1a CMS 1500
Health Insurance Claim (HIC) Number
Traditional
All claims require the complete Health Insurance Claim (HIC) number in Item 1a of the
CMS-1500 claim form or in the appropriate field for electronic claims.
Enter the patient’s Medicare HIC number exactly as it appears on the patient’s Medicare card whether Medicare is the primary or secondary payer. Enter the number without spaces and/or hyphens.
The HIC number should be nine digits followed by a valid suffix.
Example: # # # # # # # # # A
The following are examples of valid HIC number suffixes:
Code Type
A Wage earner (retirement)
B Wife
B1 Husband
C1–C9 Child (includes disabled or student child)
D Aged widow
D1 Widower
E1 Surviving divorced mother
E5 Surviving divorced father
G Claimant of lump-sum death benefits
M Uninsured – premium health insurance benefits (Part A)
M1 Uninsured – qualified for but refused HIB (Part A)
T Uninsured – entitled to HIB (Part A) under deemed or renal provisions
W Disabled widow
W1 Disabled widower
Traditional
All claims require the complete Health Insurance Claim (HIC) number in Item 1a of the
CMS-1500 claim form or in the appropriate field for electronic claims.
Enter the patient’s Medicare HIC number exactly as it appears on the patient’s Medicare card whether Medicare is the primary or secondary payer. Enter the number without spaces and/or hyphens.
The HIC number should be nine digits followed by a valid suffix.
Example: # # # # # # # # # A
The following are examples of valid HIC number suffixes:
Code Type
A Wage earner (retirement)
B Wife
B1 Husband
C1–C9 Child (includes disabled or student child)
D Aged widow
D1 Widower
E1 Surviving divorced mother
E5 Surviving divorced father
G Claimant of lump-sum death benefits
M Uninsured – premium health insurance benefits (Part A)
M1 Uninsured – qualified for but refused HIB (Part A)
T Uninsured – entitled to HIB (Part A) under deemed or renal provisions
W Disabled widow
W1 Disabled widower