Revision 21-2; Effective April 1, 2021
A | Primary Claimant |
B | Wife, 62 or over (1st claimant) |
B1 | Husband, 62 or over (1st claimant) |
B2 | Young wife with a child in her care (1st claimant) |
B3 | Wife, 62 or over (2nd claimant) |
B4 | Husband, 62 or over (2nd claimant) |
B5 | Young wife with a child in her care (2nd claimant) |
B6 | Divorced wife, 62 or over (1st claimant) |
B7 | Young wife with a child in her care (3rd claimant) |
B8 | Wife, 62 or over (3rd claimant) |
B9 | Divorced wife, 62 or over (2nd claimant) |
BA | Wife, 62 or over (4th claimant) |
BD | Wife, 62 or over (5th claimant) |
BG | Husband, 62 or over (3rd claimant) |
BH | Husband, 62 or over (4th claimant) |
BJ | Husband, 62 or over (5th claimant) |
BK | Young wife with a child in her care (4th claimant) |
BL | Young wife with a child in her care (5th claimant) |
BN | Divorced wife, 62 or over (3rd claimant) |
BP | Divorced wife, 62 or over (4th claimant) |
BQ | Divorced wife, 62 or over (5th claimant) |
BR | Divorced husband, 62 or over (1st claimant) |
BT | Divorced husband, 62 or over (2nd claimant) |
BW | Young husband with a child in his care (2nd claimant) |
BY | Young husband with a child in his care (1st claimant) |
C1-C9* | Child (minor, disabled or student) |
CA-CK | Child (minor, disabled or student) CA = C11, CB = C12, etc. |
D | Widow, 60 or over (1st claimant) |
D1 | Widower, 60 or over (1st claimant) |
D2 | Widow, 60 or over (2nd claimant) |
D3 | Widower, 60 or over (2nd claimant) |
D4 | Widow (remarried after turning 60) (1st claimant) |
D5 | Widower (remarried after turning 60) (1st claimant) |
D6 | Surviving divorced wife, 60 or over (1st claimant) |
D7 | Surviving divorced wife, 60 or over (2nd claimant) |
DB | Widow, age 60 or over (3rd claimant) |
D9 | Widow (remarried after turning 60) (2nd claimant) |
DA | Widow (remarried after turning 60) (3rd claimant) |
DC | Surviving divorced husband, 60 or over (1st claimant) |
DD | Widow, 60 or over (4th claimant) |
DG | Widow, 60 or over (5th claimant) |
DH | Widower, 60 or over (3rd claimant) |
DJ | Widower, 60 or over (4th claimant) |
DK | Widower, 60 or over (5th claimant) |
DL | Widow (remarried after turning 60) (4th claimant) |
DM | Surviving divorced husband, 60 or over (2nd claimant) |
DN | Widow (remarried after turning 60) (5th claimant) |
DP | Widower (remarried after turning 60) (2nd claimant) |
DQ | Widower (remarried after turning 60) (3rd claimant) |
DR | Widower (remarried after turning 60) (4th claimant) |
DS | Surviving divorced husband, 60 or over (3rd claimant) |
DT | Widower (remarried after turning 60) (5th claimant) |
DV | Surviving divorced wife, 60 or over (3rd claimant) |
DW | Surviving divorced wife, 60 or over (4th claimant) |
DX | Surviving divorced husband, 60 or over (4th claimant) |
DY | Surviving divorced wife, 60 or over (5th claimant) |
DZ | Surviving divorced husband, 60 or over (5th claimant) |
E | Mother (widow) (1st claimant) |
E1 | Surviving divorced mother (1st claimant) |
E2 | Mother (widow) (2nd claimant) |
E3 | Surviving divorced mother (2nd claimant) |
E4 | Father (widower) (1st claimant) |
E5 | Surviving divorced father (1st claimant) |
E6 | Father (widower) (2nd claimant) |
E7 | Mother (widow) (3rd claimant) |
E8 | Mother (widow) (4th claimant) |
E9 | Surviving divorced father (2nd claimant) |
EA | Mother (widow) (5th claimant) |
EB | Surviving divorced mother (3rd claimant) |
EC | Surviving divorced mother (4th claimant) |
ED | Surviving divorced mother (5th claimant) |
EF | Father (widower) (3rd claimant) |
EG | Father (widower) (4th claimant) |
EH | Father (widower) (5th claimant) |
EJ | Surviving divorced father (3rd claimant) |
EK | Surviving divorced father (4th claimant) |
EM | Surviving divorced father (5th claimant) |
F1 | Father |
F2 | Mother |
F3 | Stepfather |
F4 | Stepmother |
F5 | Adopting father |
F6 | Adopting mother |
F7 | Second alleged father |
F8 | Second alleged mother |
G1 – G9 | Claimants of lump-sum death payments |
J1 | Primary PROUTY entitled to HIB (less than 3 Q.C.) (General Fund) ** |
J2 | Primary PROUTY entitled to HIB (over 2 Q.C.) (RSI Trust Fund) |
J3 | Primary PROUTY not entitled to HIB (less than 3 Q.C.) (General Fund) |
J4 | Primary PROUTY not entitled to HIB (over 2 Q.C.) (RSI Trust Fund) |
K1 | PROUTY wife entitled to HIB (less than 3 Q.C.) (General Fund) |
K2 | PROUTY wife entitled to HIB (over 2 Q.C.) (RSI Trust Fund) |
K3 | PROUTY wife not entitled to HIB (less than 3 Q.C.) (General Fund) |
K4 | PROUTY wife not entitled to HIB (over 2 Q.C.) (RSI Trust Fund) |
K5 | PROUTY wife entitled to HIB (less than 3 Q.C.) (2nd claimant) (General Fund) |
K6 | PROUTY wife entitled to HIB (over 2 Q.C.) (2nd claimant) (RSI Trust Fund) |
K7 | PROUTY wife not entitled to HIB (less than 3 Q.C.) (2nd claimant) (General Fund) |
K8 | PROUTY wife not entitled to HIB (over 2 Q.C.) (2nd claimant) (RSI Trust Fund) |
K9 | PROUTY wife entitled to HIB (less than 3 Q.C.) (3rd claimant) (General Fund) |
KA | PROUTY wife entitled to HIB (over 2 Q.C.) (3rd claimant) (RSI Trust Fund) |
KB | PROUTY wife not entitled to HIB (less than 3 Q.C.) (3rd claimant) (General Fund) |
KC | PROUTY wife not entitled to HIB (over 2 Q.C.) (3rd claimant) (RSI Trust Fund) |
KD | PROUTY wife entitled to HIB (less than 3 Q.C.) (4th claimant) (General Fund) |
KE | PROUTY wife entitled to HIB (over 2 Q.C.) (4th claimant) (RSI Trust Fund) |
KF | PROUTY wife not entitled to HIB (less than 3 Q.C.) (4th claimant) (General Fund) |
KG | PROUTY wife not entitled to HIB (over 2 Q.C.) (4th claimant) (RSI Trust Fund) |
KH | PROUTY wife entitled to HIB (less than 3 Q.C.) (5th claimant) (General Fund) |
KJ | PROUTY wife entitled to HIB (over 2 Q.C.) (5th claimant) (RSI Trust Fund) |
KL | PROUTY wife not entitled to HIB (less than 3 Q.C.) (5th claimant) (General Fund |
KM | PROUTY wife not entitled to HIB (over 2 Q.C.) (5th claimant) (RSI Trust Fund) |
LM | Black lung miner (1st claimant) |
LW | Black lung miner's widow (1st claimant) |
M | Beneficiary not entitled to Title II or monthly benefits (Not qualified for automatic free Part A – HIB) |
M1 | Similar to M, but qualified for automatic free Part A – HIB, but elects to file for Part B – SMIB only |
T |
|
T2-T9 | Multiple eligible children (Medicare Qualified Government Employment (MQGE)) childhood disability benefits) |
TA | MQGE primary beneficiary |
TB | MQGE aged spouse (1st claimant) spouse |
TC | MQGE childhood disability benefits (1st claimant) |
TD | MQGE aged widow or widower (1st claimant) |
TF | MQGE father |
TG, TH, TJ, TK | Multiple eligible MQGE aged spouses |
TL, TM, TN, TP | Multiple eligible MQGE aged widow(er)s |
TQ | MQGE mother |
TE, TR, TS, TT, TU | Multiple eligible MQGE young widow(ers) |
TV, TW, TX, TY, TZ | Multiple eligible MQGE disabled widow(er)s |
W | Disabled widow, 50 or over (1st claimant) |
W1 | Disabled widower, 50 or over (1st claimant) |
W2 | Disabled widow, 50 or over (2nd claimant) |
W3 | Disabled widower, 50 or over (2nd claimant) |
W4 | Disabled widow, 50 or over (3rd claimant) |
W5 | Disabled widower, 50 or over (3rd claimant) |
W6 | Disabled surviving divorced wife (1st claimant) |
W7 | Disabled surviving divorced wife (2nd claimant) |
W8 | Disabled surviving divorced wife (3rd claimant) |
W9 | Disabled widow, 50 or over (4th claimant) |
WB | Disabled widower, 50 or over (4th claimant) |
WC | Disabled surviving divorced wife (4th claimant) |
WF | Disabled widow, 50 or over (5th claimant) |
WG | Disabled widower, 50 or over (5th claimant) |
WJ | Disabled surviving divorced wife (5th claimant) |
WR | Disabled surviving divorced husband (1st claimant) |
WT | Disabled surviving divorced husband (2nd claimant) |
* Youngest child is assigned suffix "1." When there are more than nine children in an Eligibility Determination Group (EDG), the 10th child is coded with an A rather than 10, the 11th child is coded with a B, etc. ** Quarters of covered employment. |