Application to copy or transfer from one Medicare card to another (MS011) 2025

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4.8 out of 5

129 votes

The document is an application form (MS011) for copying or transferring individuals to new or existing Medicare cards. It outlines the procedures for transferring a person from one Medicare card to another, including scenarios for children and adults. The form requires personal identification, bank account details for payments, and consent from parents or guardians for individuals under 15 years of age. It also includes information on the Medicare Safety Net and privacy notices regarding personal information.

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Click ‘Get Form’ to open the Application to copy or transfer from one Medicare card to another (MS011) in the editor.
Begin by selecting your desired action at the top of the form: choose between transferring to a new card, copying to a new card, transferring to an existing card, or copying to an existing card.
Fill in personal details for Person 1, including their Medicare card number, name, date of birth, gender, and address. Ensure all information is accurate and printed in BLOCK LETTERS.
If applicable, provide details for additional persons wanting to copy or transfer. Repeat the process for each individual by filling out their respective sections.
Complete the bank account details section if you wish for payments to be made electronically. Ensure that you provide accurate bank account information.
Review all entries for accuracy before submitting. Use our platform's features to save your progress and make any necessary edits easily.

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See more Application to copy or transfer from one Medicare card to another (MS011) versions

We've got more versions of the Application to copy or transfer from one Medicare card to another (MS011) form. Select the right Application to copy or transfer from one Medicare card to another (MS011) version from the list and start editing it straight away!

Versions	Form popularity	Fillable & printable
2022	4.8 Satisfied (129 Votes)
2021	4.8 Satisfied (120 Votes)
2016	4.4 Satisfied (118 Votes)
2013	4.3 Satisfied (60 Votes)
2012	4.1 Satisfied (68 Votes)

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Can I lookup my Medicare number with my social security number?

Your Medicare number is on your Medicare card. It is not the same as your Social Security number. You may also find your Medicare number online at your secure Medicare account or your My Social Security account.

How long does it take to get a new medicare card in the mail?

You should get your new card in the mail within 30 days.

How do I request a duplicate Medicare card?

How do you get another Medicare card? My card is lost or damaged Log into (or create) your secure Medicare account to print or order an official copy of your Medicare card. You can also call 1-800-MEDICARE (1-800-633-4227) to order a replacement card to be sent in the mail.

Can I get a picture of my Medicare card online?

You can print an official copy of your card from your online Medicare account or call 1-800-MEDICARE (1-800-633-4227 TTY 1-877-486-2048) to order a replacement card to be sent in the mail.

Is there a way to see my Medicare card online?

To get your Medicare card or number: Sign in to your MyMedicare.gov account. If you dont have an account yet, visit MyMedicare.gov to create one. You can sign in to see your Medicare Number or print an official copy of your card.