TN 18 (08-04)

RS 00301.101 Insured Status — Overview

A. Introduction

1. What is insured status?

Insured status is the earnings requirement a number holder (NH) must meet in order to establish entitlement to any type of benefit or a period of disability based on his/her earnings record (e.g., retirement, disability or survivor’s insurance benefits).

To meet insured status, the NH must have the required number of earnings credits, called “quarters of coverage” (QCs), on his/her earnings record. For certain benefits, the QCs must be earned within a specific time frame. There are several different insured status tests depending upon the type of benefit being sought. The table in RS 00301.101B of this section summarizes the various insured status tests.

NOTE: In addition, if the worker is an alien whose Social Security Number (SSN) was first assigned on or after January 1, 2004, he/she must meet additional requirements under Section 211 of the Social Security Protection Act of 2004 (Public Law 108-203) in order to be fully or currently insured and to establish entitlement based on his/her earnings. See RS 00301.102 for a full discussion of these requirements.

An alien worker whose SSN was assigned before January 1, 2004 is exempt from the requirements of section 211 of the Social Security Protection Act, even if the SSN was not “work authorized.”

2. Quarters of Coverage

The following table shows where to find more information about QCs:

TopicReference

When a calendar quarter can be a QC for years after 1977

RS 00301.210 and RS 00301.250

QCs based in self-employment income

RS 00301.220

When a quarter can be a QC for years before 1978

RS 00301.301

Assignment of QCs: flexible assignment of QCs after 1977

RS 00301.230

When a calendar quarter cannot be a QC

RS 00301.240

NOTE: Subject to the rules in RS 00301.230 and RS 00301.240, a QC for a year after 1977 may be assigned to a calendar quarter in that year that is most advantageous to the NH for the purposes of determining insured status.

B. Policy—types of insured status

1. Table of insured status tests

The following table summarizes the type(s) of insured status a Number Holder must meet for each class of benefits:

Status of the NH

Type of Benefit Sought

Then the NH must meet…

NH is living

Retirement Insurance Benefits (RIB)

Fully Insured status (RS 00301.105)

NH is living

Disability Insurance Benefits (DIB)

DIB Insured status. In general, DIB insured status means the NH must meet fully insured status and a recent work test, such as 20/40 (RS 00301.120B.1) or Special Insured Status (RS 00301.140).

See RS 00301.120 for a discussion or DIB insured status.

NH is living

Period of Disability (i.e., “Freeze,” no cash benefits)

Freeze insured status. In general, this means the NH must meet fully insured status and a recent work test, such as 20/40 (RS 00301.120B.1) or Special Insured Status (RS 00301.140).

See RS 00301.130 for a discussion of freeze insured status.

NH is living

Hospital Insurance based on end stage renal disease (ESRD), (R-HI)

Insured status for Medicare Part A for ESRD; i.e., fully insured status in RS 00301.105; or currently insured status in RS 00301.110.

(HI 00801.191C.2 and HI 00801.201.)

NH is living

Medicare for Qualified Government Employee (MQGE)

Insured status for hospital insurance (RS 00301.160 and HI 00801.410)

NH is living

On Record of Retired NH—Child’s benefits (RS 00202.001),

Fully Insured status

NH is living

On Record of Retired NH—Spouse benefits (RS 00202.001),

Fully Insured status (RS 00301.105) or Transitional Insured Status (RS 00202.015, RS 00202.020

NH is living

On Record of Disabled NH—Child’s benefits (RS 00203.001), Spouses benefits, including current and divorced spouses (RS 00202.001)

DIB Insured status. In general, DIB insured status means the NH must meet fully insured status and a recent work test, such as 20/40 (RS 00301.120B.1) or Special Insured Status (RS 00301.140).

See RS 00301.120 for discussion of DIB insured status.

NH is deceased

Child’s benefits (RS 00203.001)

Fully insured status (RS 00301.105); or

Currently insured status

(RS 00301.110)

NH is deceased

Widow(er)’s benefits (RS 00207.001)

Fully insured status (RS 00301.105);

NH is deceased

Mother’s/father’s benefits

(RS 00208.001)

Fully insured status

(RS 00301.105); or

Currently insured status

(RS 00301.110)

NH is deceased

Parent’s Benefits (RS 00209.001)

Fully insured status

(RS 00301.105)

NH is deceased

Lump-Sum Death Payment

(RS 00210.001)

Fully insured status

(RS 00301.105); or

Currently insured status (RS 00301.110)

2. Deemed fully insured status

Certain employees of private nonprofit organizations who do not otherwise meet the fully insured status test in RS 00301.105 are deemed “fully insured” for all Title II purposes, (including Medicare based on End Stage Renal Disease in Section 226A of the SSAct) if the employee meets the requirements in RS 00301.106.

3. Additional requirements for alien workers under the Social Security Protection Act of 2004

Under Section 211 of the Social Security Protection Act of 2004, an alien worker must meet additional requirements to be considered insured if his/her SSN was first assigned on or after January 1, 2004. See RS 00301.102 for a full discussion of these requirements.

C. Policy—retirement age for determining insured status

Use the following table to determine the “retirement age” for insured status purposes. NOTE: Do not use the “full retirement age” as defined in RS 00615.003 for determining insured status.

If NH is...

and was born...

then retirement age is...

Female

any time

always age 62

Male

1/2/1913 or later

age 62

Male

1/2/1911 through 1/1/1913

deemed to have attained retirement age of 62 in 1975

Male

1/1/1911 or earlier

age 65


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0300301101
RS 00301.101 - Insured Status -- Overview - 07/30/2014
Batch run: 07/30/2014
Rev:07/30/2014