You can get the number for your State by dialing 1-800-MEDICARE (1-800-633-4227) and asking for information about the Medicare Savings Program. If you are already getting railroad retirement or social security benefits, you will receive information about the Medicare program a few months before you become eligible for coverage.
Full Answer
Does railroad Medicare require authorization?
Prior authorizations requests for Railroad Medicare patients should be submitted to the jurisdictional Medicare Administrative Contractor (MAC) that will process the hospital’s outpatient department facility claim. No PA requests should be submitted to Palmetto GBA Railroad Medicare.
Is railroad Medicare different than Medicare?
There is not much difference between Railroad Medicare and regular Medicare. The first difference is that Railroad Medicare is given to railroad retirement annuitants. This type if Medicare extends to their families as well. You will want to think of this Medicare as basically like receiving Social Security benefits upon retirement.
How to verify Medicare eligibility?
- Provider Registration
- Verify Eligibility
- CoverRx
- Managed Care Organizations
- Medicare/Medicaid Crossover Claims
- Miscellaneous Provider Forms
- Pharmacy
- Report Provider Fraud
- Current P.O. Box List
- Electronic Data Interchange
What are the criteria to meet eligibility for Medicare?
- You have been receiving Social Security disability benefits for at least 24 months in a row
- You have Lou Gehrig’s disease (amyotrophic lateral sclerosis)
- You have permanent kidney failure requiring regular dialysis or a kidney transplant. This condition is called end-stage renal disease (ESRD).
How do I credential a provider with railroad Medicare?
The first step in becoming a Railroad Medicare provider is to request and receive a Railroad Medicare Provider Transaction Access Number (PTAN)....Enroll a ProviderStep 1: Ensure your Part B MAC enrollment information is correct. ... Step 2: Request a Railroad Medicare PTAN. ... Step 3: Receive your Railroad Medicare PTAN.
Is there a difference between railroad Medicare and 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.
How do I check claim status for railroad Medicare?
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.
How do I get railroad Medicare Ptan?
If you are already enrolled with your local Part B Medicare Administrative Contactor (MAC) and have a claim to submit for a Railroad Medicare patient, you will request a Railroad Medicare PTAN using the Railroad Medicare PTAN Lookup and Request Tool at www.palmettogba.com/RR/PTAN.
How much is railroad Medicare?
To enroll, you must have Medicare Part A and live in the plan's service area. You will generally pay a monthly premium (averaging about $43 in 2022) and an annual deductible (up to $480 in 2022). You must also pay a share of your prescription drug costs. Costs vary depending on the drug plan you choose.
How do I contact railroad Medicare?
Provider Contact Center: 888-355-9165 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 provides service from 8 a.m. to 4 p.m.
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.
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 Palmetto GBA Railroad Medicare?
Palmetto GBA is the Railroad Specialty Medicare Administrative Contractor (RRB SMAC) and processes Part B claims for Railroad Retirement beneficiaries nationwide.
Does Railroad Medicare require precertification?
Prior authorization may be required for Part B services provided to Railroad Medicare patients when the claim for the service will be billed to and processed by another Medicare Administrative Contractor.
What do Railroad Medicare ID numbers look like?
Medicare Numbers have 11 characters and contain numbers and uppercase letters only. They do not contain the letters S, L, O, I, B or Z. Characters one, four, seven, 10 and 11 will always be a number.
Is Ptan the same as Medicare number?
Provider Transaction Access Number (PTAN) A PTAN is a Medicare-only number issued to providers by MACs upon enrollment to Medicare. When a MAC approves enrollment and issues an approval letter, the letter will contain the PTAN assigned to the provider.
How do railroad workers enroll in Medicare?
Most railroad workers enroll in Medicare by contacting their local Railroad Retirement Board office. You can find the nearest office using the field office link above. But if you have end-stage renal disease, you must enroll through the Social Security Administration.
What is the number to call a railroad retirement board?
Call a Licensed Agent: 833-271-5571. Due to COVID-19, the Railroad Retirement Board closed offices as of March 16, 2020. We’ll keep you updated on when offices reopen. In the meantime, visit RRB.gov to learn about your online self-serve options.
What is the RRB in 2020?
Licensed Insurance Agent and Medicare Expert Writer. June 15, 2020. Before the Social Security Administration (SSA) was formed, the Railroad Retirement Board (RRB) developed retirement, disability, and unemployment benefits for railroad workers who were hit hard by the Great Depression. Today, the RRB offers railroad workers a similar safety net.
When do you become eligible for Medicare?
Typically, you’ll become eligible when you turn 65 or reach your 25th month of receiving disability benefits. The main difference is that the RRB classifies disability differently than the SSA does, so check with a representative ...
Does Medicare pay through the RRB?
Generally, your Medicare costs through the RRB will be the same as those paid by people who qualify for Medicare via Social Security. Just like workers outside the railroad industry, you’ll see Medicare deductions from your paycheck during your working years.
Does RRB have Medicare?
Today, the RRB offers railroad workers a similar safety net. RRB beneficiaries can tap into Medicare benefits, much like Social Security beneficiaries, with a few differences. If you are a railroad worker, learn what you can expect from Medicare in terms of eligibility, enrollment, costs, and health benefits—and how your RRB benefits differ ...
Do you pay Medicare Part D premiums through RRB?
If you add Medicare Part D, Medigap, or Medicare Advantage, you’ll pay additional premiums for these as well, but not through your RRB income checks. You’ll pay for each of these coverages separately, directly to the insurance company that provides each plan.
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.
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 .
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.
How to contact Palmetto GBA?
Our Provider Contact Center (PCC) representatives can be reached at 888-355-9165 (Monday – Friday, 8:30 a.m. to 4:30 p.m. ET for all time zones with the exception of PT, which receives services from 8 a.m. to 4 p.m.). To connect with an eServices representative, select option 2 from the main menu for EDI/eServices. Then select option 1 for eServices inquiries.
How to contact Railroad Medicare?
If you suspect misuse or suspicious use of the system, please contact Railroad Medicare immediately by calling our Provider Contact Center (PCC). Representatives can be reached at 888-355-9165 (Monday – Friday, 8:30 a.m. to 4:30 p.m. ET for all time zones with the exception of PT, which receives services from 8 a.m. to 4 p.m.). To connect with an eServices representative, select option 2 from the main menu for EDI/eServices. Then select option 1 for eServices inquiries.
What do I need to register for Railroad Medicare?
To register for a Railroad Medicare account, you will need your Railroad Medicare Provider Transaction Access Number (PTAN), NPI, tax ID number and the amount of the last Railroad Medicare payment you received for the PTAN/NPI combination.
How big can an attachment be on eclaims?
Users may currently submit attachments up to 40 MB in size to eClaims and forms. While there is no limit to the number for files that can be attached to the form, the combined size of all attachments cannot exceed 150 MB in size. All attachments must be in PDF format unless otherwise noted.
Can you enroll in eServices for Railroad Medicare?
You can participate in eServices for Railroad Medicare if you have a signed electronic data interchange (EDI) Enrollment Agreement on file with Palmetto GBA Railroad Medicare. If you are already submitting claims electronically to Railroad Medicare, you do not have to submit a new EDI Enrollment Agreement.
Can you add more users to a PTAN?
Only one provider administrator per PTAN/NPI combination can initially register. If you are the first person to register a PTAN/N PI combination, you will be registered as the provider administrator and can add more users through the Admin tab. You can assign back-up administrators. Keep in mind that these administrators will have access to all information functions by default. You can also add provider users who have access to individual functions , such as eligibility or claims status.
RRB Specialty MAC Providers
Effective immediately, the Railroad Medicare COVID-19 hotline can be reached at 888-882-7931 between the hours of 8:30 a.m. to 7 p.m. ET. Representatives can assist with provisional enrollment and information about accelerated payment requests. Learn More
Railroad Medicare COVID-19 Hotline
Effective immediately, the Railroad Medicare COVID-19 hotline can be reached at 888-882-7931 between the hours of 8:30 a.m. to 7 p.m. ET. Representatives can assist with provisional enrollment and information about accelerated payment requests. Learn More
Provider Contact Center: 1-888-355-9165
Call the Provider Contact Center (PCC) to speak with representatives in Customer Service, Provider Enrollment, Electronic Data Interchange, eServices and Telephone Reopenings.
Interactive Voice Response (IVR): 1-877-288-7600
Use the IVR to request routine claim status, beneficiary eligibility, and payment information and to request a duplicate remittance advice.
Email Us
Use our contact form to submit general inquiries or to provide feedback on our website. For security reasons please do not submit requests involving PHI/PII with this form.
Contact Palmetto GBA Departments
For information on contacting a specific department by phone, email, fax, or for instructions on submitting documentation by mail, please select a department:
Feedback to the Railroad Retirement Board (RRB)
If you would like to send any feedback to the RRB regarding your experience with Palmetto GBA, please direct your comments to: [email protected] .
