When the CAO determines that a budget group is eligible for MA Benefits, the CAO will review the need for ACCESS cards for each individual in the budget group. The CAO will review and issue cards as follows:
Individuals who previously received ACCESS cards - Review with the individual the need for cards and issue replacements, if needed.
An ACCESS card will automatically be issued to the following individuals:
New individuals - the system will automatically issue ACCESS cards when MA is authorized and
Inactive individuals (no prior ACCESS authorization) - the system will automatically issue ACCESS cards when MA is authorized.
The following codes are used to issue or replace ACCESS cards:
1—Not received.
2—Lost or Stolen.
3—Damaged card/ not able to use in card reader (Magnetic stripe does not work).
4—Damaged card/ by recipient or other (Folded, mutilated, etc.).
5—SSN add or change (Social Security Number added or changed which results in a change to the individual’s recipient identification number).
6—Name Change.
7—Other (Use if no other number explains situation. Explain in eCIS Case Comments).
8—Initial Card.
9—Initial Card Issuance.
The CAO will data enter the appropriate code in the eCIS Standalone module.
Important: If an eligible individual has an immediate need for medical care or services, the CAO will issue a Temporary ACCESS Card in addition to the ACCESS card.
Each ACCESS card contains the following information:
Recipient Number: Nine-digit Individual Number and one digit validation number used by medical providers and designated non-MA providers to identify individual MA eligibility.
Name of individual as displayed on eCIS Individual Inquiry Screen.
Card Issue Number: System assigned number to each card for security purposes. This number is randomly assigned and not in sequential order. The card issue number is voided when a replacement card is requested.
Magnetic Stripe (yellow card only): Coding stripe that contains information used by point of sale (POS) devices to identify eligibility for medical benefits.
Signature Panel (yellow card only): The blue signature panel is tamper proof. Advise individuals not to erase the signature.
Warning Statement to Individual.
See Appendix A for a copy of the Pennsylvania ACCESS card and the card carrier which is used to mail the ACCESS card to an individual.
See Appendix B for a copy of the Pennsylvania EBT card for MA with SNAP and Cash benefits.
ACCESS cards are mailed through the US Postal Service. The CIS nightly batch process creates a file of all card requests for each day (eCIS automated requests and CAO worker initiated replacements). The file is sent to the card contractor who has 48 hours from receipt of the file to produce and deliver the cards to the US Postal Service. The US Postal Service mails cards on the same day of delivery by the contractor to the post office.
NOTE: Direct Delivery of cash and/or SNAP benefits will not affect delivery of the ACCESS card.
An individual should receive the ACCESS card within seven calendar days of eCIS data entry completion for initial MA or card replacement.
A Temporary ACCESS Card (TAC) issued by the CAO is either mailed or picked up by the individual at the CAO and is valid for seven calendar days or until the ACCESS card is received.
The individual does not need a fixed residence, but must have a mailing address. If the individual has problems receiving mail, the CAO may be used as a mailing address. If the mailing address is not the individual’s residence, the CAO will record the residence address in the eCIS Case Comments, explaining the reasons for the discrepancy.
NOTE: The CAO will not record the residence address of an individual who is living in a shelter for abused persons.
The Post Office will not forward an ACCESS card if the individual is not at the address printed on the card carrier. A card which cannot be delivered is returned to the Central Office. The Central Office will void the card and forward it to the CAO.
Important: To ensure delivery of ACCESS cards for all budget group members, the CAO will inform individuals to notify the post office of all individuals living in the household.
ACCESS cards will be returned to the Central Office due to:
U.S. Post Office Return - These cards are destroyed by the Central Office. The Central Office perforates and writes “VOID” on the card’s envelope and returns the envelope to the CAO. The CAO is to review the case for correct address.
Lost Card Return - These cards are destroyed by the Central Office. The Central Office does not contact the CAO and does not forward lost cards to the CAO.
The CAO will determine the appropriate action to take for any cards that are returned to the CAO.
Each CAO will have a staff member designated to handle returned ACCESS cards. That person will dispose of the card as follows:
1. Maintain a list of returned cards if needed.
2. Record the reason for the return on the envelope and forward the envelope to worker for review and appropriate action.
3. Cut all cards in half and dispose of the card properly.
When an ACCESS card is returned to the CAO, the CAO will:
1. Review to determine if an address change has been reported. Review individual information on the card for correctness.
NOTE: It is the responsibility of the individual to inform the CAO of a change in address or circumstances. However, the CAO must ensure that medical benefits continue for eligible individuals who are hospitalized and unable to advise the CAO of their circumstances.
2. Change the address and/or individual information. Authorize a replacement card if the information that appears on the card has been changed (Example: name change). If a valid ACCESS card was returned to the CAO, return card to the individual.
3. If the budget group has not reported an address change or nonreceipt of cards, the CAO will:
Review eCIS to ensure that the CAO has correctly data entered the information.
If eCIS is correct, follow returned mail procedures outlined in MAEH 323.7 Individual Whose Location is Unknown.
The CAO will handle damaged cards as follows:
1. Ask the individual to explain the card damage if the card is not visibly damaged (folded, print not readable, edges bent, etc.).
NOTE: It is important to identify cards with a defective magnetic stripe. Only cards identified with a defective magnetic stripe are replaced in eCIS using code 3.(Newly issued cards will no longer contain the magnetic strip.)
2. Issue a manual replacement card in the eCIS Standalone module.
3. Complete a HS 764 attach the damaged card to the form and forward to the designated staff member in the CAO who handles damaged ACCESS cards.
ACCESS cards need to be returned to Harrisburg if they are replaced with the following issuance codes:
Code 3—Damaged card; not able to use card in card reader due to a defective magnetic stripe.
Code 4—Damaged card by recipient or other (folded, mutilated, etc.).
These cards will be examined to ensure the card contractor is upholding card production standards.
A function of the CAO is to identify individuals who abuse or defraud the MA Benefits Program. A provider may notify the CAO that an individual is abusing their MA services or defrauding the MA program.
Individuals who have been determined to be abusing, misusing, or defrauding the MA Benefits Program may have restrictions placed on their ACCESS card. The Managed Care Organization (MCO) completes the restriction process. The process involves an evaluation of the degree of abuse, a determination if the individual should be restricted, notification of the restriction, and the evaluation of subsequent MA services.
If an individual reports that the ACCESS card is not working the CAO can inquire through eCIS to confirm if there is a restriction placed on the card.
1. The CAO will access the Individual ACCESS Card Maintenance screen of the case to review the Lock-In indicator field (LK).
2. The LK field will show either:
N—None.
Y—Yes, restriction(s) exist.
NOTE: the Lock-In indicator field will only be populated for MA only cases.
The CAO can obtain further details of the restriction(s) placed on the ACCESS card by accessing the PROMISe system:
1. Login to PROMISe.
2. Click the Eligibility tab on the top of the page.
3. Select the Lock-In option.
4. Enter the Individual’s Recipient Identification Number (RID).
5. If Lock-In data is present, it will be displayed on the screen.
Updated January 23, 2025 Replacing July 24, 2024