Railroad Medicare is Part B Medicare for Railroad Retired Employees, Often Their Dependents and Survivors
Railroad Medicare, Part B Medicare, provides coverage for services (such as doctors’ visits, ambulance transports, lab tests, to name a few) and some supplies when determined to be medically reasonably necessary. Benefits are the same for eligible individuals, whether eligibility is through Railroad Retirement or Social Security.
Railroad Medicare is funded by a portion of the Railroad Retirement Tier I and Social Security payroll taxes paid by employees and employers. Monthly premiums are also applied to the program.
There are times when Medicare participating providers and suppliers don’t understand that if they accept Medicare Part B, this includes Railroad Medicare too.
The Centers for Medicare and Medicaid (CMS) has incorporated information about Railroad Medicare in its online manual publications pertaining to Medicare Policy and Regulation. The CMS manual states:
“Carrier jurisdiction claims for individuals who are QRRBs [Qualified Railroad Retirement Beneficiaries], including those who are entitled to both social security and railroad retirement benefits, are handled by the Palmetto Government Benefits Administrators (GBA) LLC, a subsidiary of Blue Cross and Blue Shield of South Carolina.”
The CMS also includes information about Railroad Medicare in its annual ‘Medicare & You’ booklet mailed to Medicare patients every year.
When Palmetto GBA conducts educational events or speaks one-on-one with providers and suppliers, we always explain what Railroad Medicare is and confirm that Medicare Part B benefits are standard nationwide.
If a provider/supplier you want to go to participates in Medicare but states 'not Railroad Medicare', we recommend they call our Provider Contact Center at 888-355-9165. Our staff is trained to discuss these matters with all Part B providers and suppliers. We also recommend they visit our website at www.PalmettoGBA.com/RR.
If you have questions about your Part B coverage, you may call our Beneficiary Contact Center at 800-833-4455, Monday through Friday, from 8:30 a.m. to 7 p.m. ET.
We also encourage you visit our beneficiary website at www.PalmettoGBA.com/RR/Me and sign up for email updates. To do so, visit our website and click ‘Listservs' on the top of this Web page.