Contact Railroad Medicare Claims
- Self-Service. Our eServices portal allows you to submit online paperless eClaims and check the status of submitted...
- Call 888-355-9165, select Option 5 for Customer Service. Representatives are available Monday through Friday from 8:30 a.
- Fax. Railroad Medicare does not accept CMS-1500 claim forms via fax.
- Submit Documentation.
- Provider Contact Center: 888-355-9165.
- IVR: 877-288-7600.
- TTY: 877-715-6397.
How do I submit railroad Medicare?
You can either file electronic claims to Railroad Medicare through a clearinghouse or other third-party claims submitter, or you can submit paperless claims directly through Palmetto GBA's online provider portal eServices eClaims option.
How do I find my railroad Medicare claims?
If you'd like to use the IVR, you can do so by calling 800–833–4455. From the main menu, press one (1) for claim status. You will need your Railroad Medicare number, date of birth, name, and date of service for the claim you are searching for. Claim status is available Monday thru Friday from 7 a.m. through 11 p.m. ET.
Does railroad Medicare have a provider portal?
Events. Palmetto GBA Railroad Medicare is pleased to offer eServices, our free Internet-based, provider self-service portal. The application provides information access over the Web for the following online services: Eligibility.
Who administers railroad Medicare?
Palmetto GBA is contracted by the independent federal agency Railroad Retirement Board (RRB), which administers comprehensive retirement-survivor and unemployment-sickness benefit programs for railroad workers and their families under the Railroad Retirement and Railroad Unemployment Insurance Acts.
Is railroad Medicare the same as regular Medicare?
A: The only difference is that retired railroad beneficiaries have their Part B benefits administered by the Palmetto GBA Railroad Retirement Board Specialty Medicare Administrative Contractor (RRB SMAC) regardless of where they live. Members should be certain to advise providers of this when they receive treatment.
What is Medicare railroad?
The Federal Medicare program provides hospital and medical insurance protection for railroad. retirement annuitants and their families, just as it does for social security beneficiaries.
What is the payer ID for Medicare Railroad?
MR018Payer Name: Medicare - Railroad|Payer ID: MR018|Professional (CMS 1500)
How do I contact Palmetto GBA?
For inquiries regarding provider enrollment, please call the Provider Contact Center at 855–696–0705. For education, please complete the Education Request form. To access this document, go to the Forms web page at www.PalmettoGBA.com/hhh/forms. Provider inquiries, please call 855–696–0705.
How do I check my railroad retirement benefits?
To access your benefit information by telephone: Call the Railroad Retirement Board at 877-772-5772. Press "1" to select our automated HelpLine services.
Is railroad Medicare a Medicare Advantage Plan?
Yes, Railroad Medicare beneficiaries can choose to enroll in Medicare Advantage plans.
Do spouses get Railroad Retirement?
The Railroad Retirement Act is a Federal law that provides retirement and disability annuities for qualified railroad employees, spouse annuities for their wives or husbands, and survivor benefits for the families of deceased employees who were insured under the Act.
Who is in charge of the Railroad Retirement Board?
A three-member Board appointed by the President of the United States, with the advice and consent of the Senate, leads the RRB.
Call 888-355-9165, select Option 5 for Customer Service
Representatives are available Monday through Friday from 8:30 a.m. to 4:30 p.m. for all time zones with the exception of PT, which receives service from 8 a.m. to 4 p.m.
Contact a Different Department
View our main Contact Us page for information on how to submit a general inquiry or to contact a different department.
Who is in charge of Medicare?
CMS is the agency in charge of the Medicare program. The Railroad Retirement Board (RRB) enrolls railroad retirement beneficiaries in the program, deducts Medicare premiums from monthly benefit payments, and assists in certain other ways.
Who is eligible for Medicare?
Eligibility for family members age 65 or older. -- Under certain conditions, your spouse, divorced spouse, surviving divorced spouse, widow (er), or a dependent parent may be eligible for Medicare hospital insurance based on your work record when he or she turns 65.
What is the enrollment period for Medicare?
Special Enrollment Period for People Covered Under a Group Health Plan#N#If you are age 65 or older and covered under a group health plan, either from your own or your spouse’s current employment, you have a special enrollment period in which to sign up for Medicare Part B. This means that you may delay enrolling in Medicare Part B without having to wait for a general enrollment period and paying the 10 percent premium surcharge for late enrollment. The special enrollment period rules allow you to: 1 enroll in Medicare Part B anytime while you are covered under the group health plan based on current employment; or 2 enroll in Medicare Part B during the 8-month period that begins the month after your group health coverage ends or employment ends, whichever comes first.
What is Medicare Part A?
Hospital Insurance ( Medicare Part A ), which helps pay for inpatient care in hospitals and skilled nursing facilities (following a hospital stay), some home health care services, and hospice care.
How long do you have to be on Medicare to get free medical insurance?
If you are under age 65.-- Before age 65, you are eligible for free Medicare hospital insurance if you have been entitled to monthly benefits based on a total disability for at least 24 months and have a disability insured status under social security law. If you are entitled to monthly benefits based on an occupational disability, and have been granted a disability freeze, you are eligible for Medicare starting with the 30th month after the freeze date or, if later, the 25th month after you became entitled to monthly benefits. If you receive benefits due to occupational disability and have not been granted a disability freeze, you are generally eligible for Medicare hospital insurance at age 65. (The standards for a disability freeze determination follow social security law and are comparable to the medical criteria for granting total disability.) You are also eligible for Medicare if you have Lou Gehrig’s disease (amyotrophic lateral sclerosis).
What age does Medicare cover?
Medicare is our country’s health insurance program for people age 65 or older, certain people with disabilities who are under age 65, and people of any age who have permanent kidney failure.
When does Medicare Part B become effective?
When does your enrollment in Part B become effective? If you accept the automatic enrollment in Medicare Part B, or if you enroll in Medicare Part B during the first 3 months of your initial enrollment period , your medical insurance protection will start with the month you are first eligible. If you enroll during the last 4 months, your protection will start from 1 to 3 months after you enroll.
Call 1-800-833-4455
Representatives are available Monday through Friday from 8:30 a.m. until 7:00 p.m. ET.
Contact a Different Department
View our main Contact Us page for information on how to submit a general inquiry or to contact a different department.
Call 888-355-9165, select Option 5 for Customer Service
Representatives are available Monday through Friday from 8:30 a.m. to 4:30 p.m. for all time zones with the exception of PT, which receives service from 8 a.m. to 4 p.m.
Telephone Reopenings
Some denials can be adjusted via telephone reopening (restrictions apply.) To request a claim reopening by telephone:
Submit Documentation
If you are unable to submit your appeals via our eServices portal , please submit your completed appeals forms and documentation using one of the methods noted below:
Contact a Different Department
View our main Contact Us page for information on how to submit a general inquiry or to contact a different department.
Your Opinion Matters
Please take a moment to complete our Redetermination – 1st level appeal survey. These questions are only related to your 1st level of appeals, the Redetermination.
Where is the railroad retirement board on my Medicare card?
Your Medicare card is similar to the new Medicare cards that all beneficiaries receive, with the exception that “Railroad Retirement Board” is printed in a red banner at the bottom of the card .
What Medicare Parts are automatically enrolled in if you receive a railroad retirement?
If you receive Railroad Retirement benefits or disability annuity benefits from the railroad at the time of eligibility for Medicare, you are automatically enrolled in Medicare Parts A and B by the RRB.
Does Medicare cover railroad employees?
Medicare offers coverage to railroad employees just as it does for people who have Social Security. The payroll taxes of railroad employees include railroad retirement and Medicare hospital insurance taxes.
Do you have to go through the Social Security Administration if you are employed by the railroad?
However, if you have end-stage renal disease (ESRD) and qualify for Medicare, you must go through the Social Security Administration even if you are employed by the railroad.
Does Medicare work with railroad retirement?
If you or a loved one is retiring form the U.S. Railroad Retirement Board (RRB), you may be wondering how your benefits will work with Medicare . The RRB administers insurance and retirement benefits to all railroad workers in the country. Instead of getting retirement benefits from the U.S. Social Security Administration as other workers do, the RRB provides railroad workers and their families with retirement benefits, along with unemployment and sickness benefits, Medicare will still be responsible for the individual’s health care benefits.
What is a PTAN for Medicare?
Before billing Railroad Medicare, you must be enrolled with and have a Provider Transaction Access Number (PTAN) for your local Part B MAC. Because Railroad Medicare’s enrollment records will match what your local MAC has on file, please make sure your enrollment information is current with your MAC before requesting a Railroad Medicare PTAN.
Can you receive Medicare payments from railroad?
EFT allows a financial institution to deposit Railroad Medicare payments directly into a designated account. Once you have been established to receive funds EFT, you will no longer be eligible to receive your Railroad Medicare payments via paper checks.