Railroad Medicare - Understanding the Basics

Railroad Medicare – Understanding the Basics

Railroad Medicare is the name given to individuals receiving benefits from the Railroad Retirement Board (RRB), whose benefits are designed for workers and family's under the auspices of the Railroad Retirement and Railroad Unemployment Insurance Acts.

Benefits are offered to individuals who have worked 10 or more years of railroad service. Retirement benefits for such employees are determined by the Retirement Board, while services, claims, benefits, eligibility and enrollment is provided through Railroad Medicare:

Palmetto GBA Railroad Medicare Part B P.O. Box 10066, Augusta, Georgia 30999

They may also be reached through their customer service at 1-(888)-355-9165. IVR: 877-288-7600 TTY: 877-715-6397

Palmetto GBA has been offering these services in conjunction with the Centers for Medicare and Medicaid Services (CMS) for four decades and is the Part B carrier for RR Medicare throughout the nation, contracted by the Railroad Retirement Board for retirement/survivors, and unemployment/sickness benefit programs for workers and their families.

railroad medicare

What Does it Cover?

It basically covers the same as traditional government services, except that beneficiaries are RR retirees. The plan contains Part A benefits, covering hospitalization costs similar to those found in traditional Medicare Part A. Part B is paid for by monthly premiums from Federal government funding revenues or by individuals, determined by employment history.

As with traditional services, Part B coverage offers help in paying for services provided by physicians and physician-based medical services not covered in Part A, which includes doctors services, laboratory services, outpatient hospital services, preventive services, and Home Health Care Services, and many other benefits.

Part A medical benefits include hospital insurance, which helps to pay for skilled nursing facilities following a hospital stay, and inpatient care in a hospital, as well as some hospice care and Home Health Care Services.

RR Medicare offers coverage to railroad workers in a similar format as those covered under Social Security benefits, and railroad retirement payroll taxes also include hospital insurance tax for Medicare, just like Social Security taxes do.

For those retiring from railroad service, the Railroad Retirement Board enrolls employees into the program, and premiums are generally deducted from monthly benefit payments.

Enrolling in Railroad Medicare

Individuals who have worked for a minimum of 10 years in their railroad industry may pre-enroll or enroll in this plan. Enrollment forms, known as the EDI Enrollment Packet, are available from Palmetto GBA. Otherwise, eligibility standards are the same for those receiving Railroad Medicare as those receiving Medicare in the general population through the Social Security Administration. Individuals 65 years of age or older are eligible for Medicare Part A (hospital insurance), at no cost if they are able to receive Social Security benefits or Railroad Retirement benefits.

Individuals are also eligible for services if they are under 65 years of age and are suffering from permanent disabilities, or if a senior has been diagnosed with Lou Gehrig's disease (amyotrophic lateral sclerosis), or have been diagnosed with permanent kidney failure or if the senior receives occupational disability under certain circumstances.

Benefits

Individuals submit claims to the Centers for Medicare and Medicaid Services (CMS) or a designated CMS contractor, through its agents, or employers.

Individuals working in the railroad industry should contact Medicare regarding Railroad Retirement Benefits at Railroad Benefits to read RB-20 January 2010 - Medicare for Railroad Workers and their Families to access the information booklet in its entirety. Additional questions may be broached to Palmetto GBA for clarification regarding eligibility, enrollment periods, claims processing, or answers to general questions and facts regarding benefits and services.

Conclusion

RR workers may also access information and guidance through employee insurance agents regarding specifics regarding coverage and benefits in their geographical region.

While the details of Medicare services and benefits may be confusing to many, seniors taking the time to research, understand basic terminology, and access various sources of information, including web sites, will benefit in greater understanding of RR Medicare benefits for themselves and their families.


Editors Note: As with any benefits information discussed on this web site please always access the source for additional information. The web site can be viewed at Railroad Benefits


Medicare and Medicaid Page


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