Medicare Data

The Medicare information provided on the hard copy IEVS applicant abstract or through MEDS will identify the premium payment and current or previous buy-in status for either Part A or Part B coverage. This information can be used to identify if there is a need to refer an individual for Medicare benefits as a condition of Medi-Cal eligibility.

Note: The Medicare Data is not yet available through the CalSAWS Applicant IEVS Report system due to a programming glitch.

Medicare Data: The following table explains data elements on the Medicare portion of the abstract:

Field

Definition

Medicare Data (Part A and B)

Part A and B Medicare:

START: Date of the entitlement to HI/SMI.

STOP: Most recent date of termination of HI/SMI.

PREMIUM: Amount of HI/SMI that is being paid or deducted from the benefit check.

BUY-IN: Indicates (Y/N) that a third party is paying, or has paid, the premium for HI/SMI.

START: Month/year a third party started paying the HI/SMI premium.

STOP: Last month/year a third party paid a HI/SMI premium.

Cross-reference Claim Number

Indicates if an additional SSN is used by the individual or if another claim number is being used to receive benefits. An SSN followed by an “M" indicates multiple SSNs. An SSN followed by a BIC indicates the individual is receiving Title II benefits under another claim number.

40 Quarters Data

The 40 Quarters Data window displays information needed to make eligibility determinations for CalWORKs and CalFresh.

The following data is available on the 40 Quarters Data report abstract:

  • Reported by SSA as of date
  • Total number of qualifying quarters
  • Number of qualifying quarters after 1996
  • A table displaying the 40 Quarters Data in year and quarter format
    • All years are shown starting with 1937
    • [Yes] or [No] is displayed for each quarter to indicate whether or not the quarter met SSA’s requirements to be counted as a qualifying quarter.

Reminder: Refer to the CalFresh and CalWORKs Handbooks to determine IF a qualifying quarter earned AFTER 1996 can be used to meet the federal eligibility criteria.

Related Topics

SSA Data and Interfaces Overview