Medicare cardholders ¶

Overview ¶

This use case describes a feature in Cal-ITP Benefits that allows eligible riders to verify their active participation in the Medicare program to receive reduced fares for transit when paying by contactless debit or credit card at participating transit operators in California.

Actor: A person who uses public transit in California. For benefit eligibility, a Medicare cardholder is a person who has enrolled in the Medicare program, has a Medicare.gov account, and is not deceased.

Goal: To verify a transit rider’s Medicare status so they receive reduced fares when paying by contactless debit or credit card.

Precondition: The transit operator offers fixed route service, has installed and tested validator hardware necessary to collect fares using open-loop payments on bus or rail lines, and has a policy in place to offer a transit benefit to riders enrolled in Medicare.

Demonstration ¶

Here’s a video walkthrough of the self-service enrollment experience when choosing the Medicare cardholder enrollment pathway.

Self-service enrollment ¶

sequenceDiagram
autonumber
%% Self-service Enrollment for Medicare Cardholders
    actor TransitRider as Transit Rider
    participant Benefits as Cal-ITP Benefits
    participant IdG as Identity Gateway
    participant Medicare as Medicare.gov
    participant BBAPI as Blue Button API
    participant TransitProcessor as Transit processor
TransitRider->>Benefits: visits benefits.calitp.org
    activate Benefits
Benefits-->>IdG: begins identity verification
    activate IdG
TransitRider->>Medicare: account authentication
    activate Medicare
    Note over Medicare: Authenticated (Y/N)
Medicare-->>IdG: authentication confirmation
    deactivate Medicare
IdG-->>BBAPI: sends required PII
    activate BBAPI
    Note over BBAPI: Deceased (Y/N)
BBAPI-->>IdG: returns response
    deactivate BBAPI
IdG-->>Benefits: eligibility response
    deactivate IdG
Benefits-->>TransitProcessor: card registration start
    activate TransitProcessor
TransitRider->>TransitProcessor: provides debit or credit card details
TransitProcessor-->>Benefits: card registration confirmation
    deactivate TransitProcessor
    deactivate Benefits
    Note over Benefits: Successfull enrollment

The transit rider visits the web application at benefits.calitp.org in a browser on their desktop computer or mobile device.
The transit rider chooses the transit operator that serves an area where they want to ride public transit.
The transit rider chooses to verify their eligibility as a Medicare cardholder.
The Cal-ITP Benefits app interfaces with the California Department of Technology Identity Gateway (IdG) to verify rider identity and benefit eligibility.
The transit rider authenticates with their Medicare.gov account or, if they don’t have one, creates a Medicare.gov account using their Medicare card.
The transit rider consents to share information from their Medicare.gov account to verify their eligibility for a transit benefit.
The IdG uses the response provided by the Blue Button API to determine the rider’s eligibility for a transit benefit.
The IdG then passes an eligibility response as Medicare enrollment status = TRUE to the Cal-ITP Benefits app to indicate the person is eligible for a benefit.
The transit rider provides the debit or credit card details they use to pay for transit to the transit processor that facilitates fare collection for the transit provider.
The app registers the transit rider’s debit or credit card for reduced fares.

Alternative self-service flows ¶

Suppose the transit rider cannot authenticate with Medicare.gov, or will not create an account. In either case, the app cannot determine their Medicare status and they cannot enroll their contactless debit or credit card for a reduced fare.

Suppose the CDT Identity Gateway returns Medicare enrollment status = FALSE. In that case, the Cal-ITP Benefits app will not allow the transit rider to register their contactless debit or credit card for a reduced fare.

Suppose the debit or credit card expires or is canceled by the issuer. In that case, the transit rider must repeat the basic flow to register the new debit or credit card.

If the transit rider uses more than one debit or credit card to pay for transit, they repeat the basic flow for each card.

In-person enrollment ¶

sequenceDiagram
autonumber
%% In-person Enrollment for Medicare cardhold
    actor Transit_Rider as Transit Rider
    participant location as Agency Office
    actor Agency_Staff as Agency Staff Member
    participant Benefits as Cal-ITP Benefits Administrator
    participant Fare_processor as Fare processor
Transit_Rider->>location: visits a physical location or enrollment event
Agency_Staff->>Benefits: starts in-person enrollment
    activate Benefits
Agency_Staff->>Benefits: chooses enrollment pathway
Transit_Rider->>Agency_Staff: shares government-issued photo ID +<br> Medicare card
Agency_Staff->>Benefits: verifies eligibility
    Note over Benefits: eligible (Y/N)
Fare_processor-->>Benefits: card registration form
    activate Fare_processor
Transit_Rider->>Fare_processor: enters debit or credit card details
Fare_processor-->>Benefits: card registration confirmation
    deactivate Fare_processor
    deactivate Benefits
    Note over Benefits: Successful enrollment

The transit rider visits an agency office or enrollment event in person.
A transit provider staff member logs into Cal-ITP Benefits Administrator, typically on a tablet device.
The transit provider staff member launches in-person enrollment and chooses Medicare cardholder as the eligibility type.
The transit rider hands the transit provider staff member their government-issued photo ID and Medicare card.
The transit provider staff member confirms the person’s identity and verifies that the Medicare card indicates the person is an active enrollee.
The transit provider staff member hands the transit rider the tablet so they can enter the debit or credit card details for the card they use to pay for transit into the form provided by the transit processor that facilitates fare collection for the transit provider.
The app registers the transit rider’s debit or credit card for reduced fares.

Postcondition ¶

The transit rider receives a fare reduction each time they use the debit or credit card they registered to pay for transit rides. The number of times they can use the card to pay for transit is unlimited and the benefit never expires.

Benefits ¶

The transit rider no longer needs cash to pay for transit rides.

The transit rider doesn’t have to lock up funds on a closed-loop card offered by the transit operator.

The transit rider pays for transit rides with the same contactless debit or credit card they use for everyday purchases.

The transit rider can enroll in a transit benefit from home when it is convenient for them; they are not required to visit a transit provider office in person unless they choose the in-person enrollment method.

Secure state and federal solutions manage the transit rider’s personal identifiable information (PII): Medicare.gov, the Blue Button API, and the California Department of Technology Identity Gateway (IdG). Transit riders do not have to share personal information with local transit operators.

Benefit enrollment takes minutes rather than days or weeks.

Benefit enrollment doesn’t require online accounts with private companies.

Example Scenario ¶

A 46-year old person with End-Stage Renal Disease (ESRD) uses public transit to get to and from dialysis treatments. They have undergone dialysis treatments for the last four months and are now covered by Medicare. In order to save on transportation expenses, they scheduled an appointment with their local transit provider and made a special trip to complete the in-person eligibility process to qualify for reduced transit fares. They now receive a 50% fare reduction but have to pay for transit rides using the closed-loop card provided by the operator to receive the reduced fare. It’s frustrating and inconvenient to reload this closed-loop agency card in $10 increments every week, especially because they sometimes could use the money tied up on the card to make ends meet. In summary, this person pays for daily expenses using several forms of payment: their agency card for transportation and their debit card or cash for everything else.

The transit operator serving their region of California implements open-loop payments on fixed bus routes throughout the service area. This rider opens the Cal-ITP Benefits web application at home, completes the self-service workflow to digitally confirm they are enrolled in Medicare, and registers their debit card for reduced fares. If the rider doesn’t want to create a Medicare.gov account, they visit the transit provider office and complete enrollment in person. Now, when they tap-to-pay when boarding the bus, they are automatically charged the reduced fare. They no longer need to use their closed-loop agency card to pay for transit and have complete access to all funds in their weekly budget.