Traveling/Snowbird Beneficiary

When a claim is filed with Medicare, the beneficiary’s permanent address on file with the Social Security Administration (SSA) determines which Medicare jurisdiction should be billed. This address should be entered in Item 5 of the CMS-1500 Claim Form. This can always be found on the Noridian Medicare Portal (NMP) by selecting the Eligibility tab, then select Beneficiary Address.

  • Patient's Address and Telephone Number
    This is a required field and must be filled in completely.
    • Enter the patient's permanent mailing address as listed with Social Security Administration and telephone number.
    • On the first line, enter the street address; on the second line, the city and state; and on the third line, the ZIP code and telephone number.

Example Checking Eligibility for Permanent Address:

  • Beneficiary was provided a walker in Jurisdiction D after a fall
  • Supplier checks Noridian Medicare Portal (NMP) for eligibility
  • The NMP shows beneficiary’s permanent address on file with SSA is Jurisdiction A
  • Supplier will bill Jurisdiction A by adding the permanent address listed with SSA to Item 5 of the CMS-1500 claim form
  • Fee schedule is based on beneficiary’s permanent state of residence with SSA

Example Sending Supplies to Traveling Beneficiary:

  • Beneficiary originally set up in Jurisdiction A for glucose supplies
  • Beneficiary temporarily resides in or visits Jurisdiction D part time
  • Supplier checks Noridian Medicare Portal (NMP) for eligibility
  • The NMP shows beneficiary’s permanent address on file with SSA is still Jurisdiction A
  • Supplier from Jurisdiction A sends supplies to beneficiary residing temporarily in Jurisdiction D
  • Supplier will bill claims in Jurisdiction A based on beneficiary's permanent address listed with SSA

Billing always follows the beneficiary's permanent address with SSA. This can always be found under the Eligibility tab on the NMP, then select Beneficiary Address.

Note: When billing or filing claims electronically and the beneficiary’s permanent address on file with Social Security is entered in the address field of the claim, the Common Electronic Data Interchange (CEDI) will route the claim to the correct Medicare jurisdiction.

 

Last Updated Jun 22 , 2023