Check a patient's Medicare eligibility

Last updated: October 2, 2026

The Medicare eligibility card in the side panel shows whether a patient's Original Medicare coverage is active, plus key coverage details.

Before you start

  • The card checks Original Medicare only, not commercial plans or Medicare Advantage benefits.
  • Your practice needs to be set up for Medicare checks. Until then, the card says they aren't set up (or are paused). Email support@aflowhealth.com to get set up.

Automatic checks

If your schedule syncs from your EHR, aflow checks patients who have a Medicare ID on file and an appointment in the next seven days, unless they were checked in the past seven days. Patients enrolled in APCM are also checked monthly.

Check a patient yourself

  1. Open the patient's chart in your EHR.
  2. On the Medicare eligibility card, select the action shown:
    • Check now checks the Medicare ID from the chart.
    • Add ID asks for the 11-character Medicare number (MBI) from the patient's card. Enter it and select Save and check.
  3. Wait while the card shows Checking Medicare…

To check again later, open the card's menu and choose Recheck now. To change the ID, choose Edit Medicare card details. What you enter is saved in aflow and doesn't change the chart in your EHR.

Walk-in or new patient

With no chart open, select Check Medicare for a walk-in or new patient on the side panel home. Enter the name, date of birth, and Medicare ID, then select Check Medicare coverage. aflow adds the patient if they're new and opens them with the result.

Read the result

  • Medicare: Active or Inactive.
  • Plan: Original Medicare.
  • Part A and Part B: effective dates, when reported.
  • QMB: whether the patient is a Qualified Medicare Beneficiary.
  • Part B deductible: the amount left, Met, or Do not collect for QMB patients.
  • Annual wellness visit (AWV): Eligible now or the next eligible date, with its code.

Unknown means Medicare didn't report that item. The footer shows the end of the Medicare ID and when the last check ran. If Medicare reports a Medicare Advantage plan, the card shows only the plan name, so check benefits with that plan.

If a check fails or shows no coverage

  • Medicare didn't recognize the ID or Medicare ID on file isn't valid: select Fix ID and correct the number.
  • Name or date of birth doesn't match Medicare (or Date of birth doesn't match Medicare): select Fix and enter the name and date of birth exactly as printed on the Medicare card.
  • Last Medicare check failed or Still waiting on Medicare: select Try again.
  • Inactive: confirm the patient's current coverage with them.

If a newer check fails, the card keeps the last good result and notes when the check failed. Automatic checks don't retry a failed check right away, so fix the issue and check again. If a result looks wrong, choose Give feedback from the card's menu.