Beneficiary Data Files

File Selection Guide
This matrix provides a quick guide for determining which Medi-Cal Beneficiary file has the information you need.
 
View the latest Medi-Cal Beneficiary Profiles by County data ONLINE
(includes demographic data: county of eligibility, age, gender, aid category, ethnicity, language, Medicare, and plan type)
note: these pages use frames This data can still be downloaded in it's original Excel format from the following page Medi-Cal Beneficiary Profiles by County (updated quarterly)

Medi-Cal Beneficiary Counts, Historical (updated monthly)
(includes demographic data: county of eligibility, aid code, aid category, and month of eligibility for January 2001 forward)

Medi-Cal Beneficiary Counts, Medicare/Medi-Cal Pivot Table (updated monthly)
(includes demographic data for Medicare related aid codes (80, 8A, 8C, and 8D): county of eligibility,  aid code, health care plan, age, other health coverage, special aid code, special aid code county, Medicare part A B D, and month of eligibility for January 2003 forward)

Medi-Cal-Related Children Eligibles, Historical (updated monthly)
(includes demographic data for Miscellaneous Children-Medi-Cal-related aid codes (Healthy Families & CHDP - 7X, 7Y, 8X, and 8Y): county of eligibility, aid code, age category,  other health coverage and month of eligibility for January 2003 forward)

Medi-Cal Beneficiaries by Zip Code (updated quarterly)
(includes demographic data: county of eligibility, age, gender, aid category, ethnicity, language, Managed Care plan, and Medicare A/B)

Medi-Cal Beneficiary Counts (includes Special Family categories - updated monthly)
(includes demographic data: county of eligibility, aid code, aid category, age, managed care vs. FFS, and month of eligibility for January 2006 forward)

Medi-Cal Beneficiaries - Share of Cost (updated monthly)
(includes Medi-Cal eligibles by county, aid code, share of cost amount and month of eligibility for January 2005 forward)

Medi-Cal Beneficiaries by Managed Care Plan (updated monthly - historical)  
(includes demographic data: county of eligibility, aid code, Managed Care plan, and month of eligibility for January 2003 forward)

Medi-Cal Beneficiaries by Age/Demographics (updated quarterly)
(includes demographic data:  age category, county, gender, plan type (FFS vs. Managed Care),
aid code, aid category, ethnicity, and language)

Medi-Cal Beneficiaries by Age Category (updated quarterly - historical )
(includes demographic data: county of eligibility, age, gender, plan type (FFS vs. Managed Care), and quarterly month of eligibility for January 1998 forward)

The Medi-Cal Services and Expenditures Month of Payment Summary Reports 
can now be found on the MCSS Utilization Data Files Page

Some of these files were created in Microsoft Excel and utilize a Pivot Table.
Note that a Pivot Table was added to permit the user to summarize and analyze the data interactively.
For more information about the elements of a Pivot Table please go to the Microsoft website at:
http://office.microsoft.com/en-us/assistance/HA010346321033.aspx
-or-
You can visit the MCSS General Information page and view MCSS's
Tips for Manipulating Microsoft's Excel Pivot Tables

Please note that recent changes to the Health Insurance Portability and Accountability Act (HIPAA) have added new restrictions as to the type of entities that can receive personal medical data and the purposes for which the data can be used. Please refer to HIPAA Privacy Rule Information page for more information.

Note:  as our Department normally uses the term, "Medi-Cal eligible" is someone who is on Medi-Cal. If there is a share of cost (SOC) that must be paid before Medi-Cal picks up the remaining costs of care, such a person could be certified or uncertified, that is, he/she met their SOC for that month or they haven't, respectively. If "certified" and uncertified are not used when describing "eligible," "certified is normally implied. The term "beneficiary" usually means a Medi-Cal eligible who, if normally construed to mean a Medi-Cal eligible enrolled in a Medi-Cal managed care plan.

The terms "eligible," "beneficiary," and "enrollee" are used interchangeably within Medi-Cal. Each refers to a person who meets all requirements for receiving a Medi-Cal medical service or good (e.g., drugs, DME items) and is enrolled in the Medi-Cal program by the Department.

Please send comments and suggestions regarding the Medical Care Statistics Section Website to: Medical Care Statistics Section