Medicare Blog

how to verify benefits with railroad medicare

by Prof. Elvera Sporer Jr. Published 2 years ago Updated 1 year ago
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If you do not have access to the Internet, you can either call 1-800-MEDICARE (1-800-663-4227) or the Palmetto GBA Railroad Medicare Beneficiary Contact Center (1-800-833-4455), and Customer Service staff can do the search with you on the telephone. The RRB SMAC Customer Service Line is available Monday through Friday, from 8:30 a.m. to 7 p.m. ET. For the hearing impaired, call TTY/TDD at 877-566-3572. This line is for the hearing impaired with the appropriate dial-up service and is available during the same hours Customer Service Representatives are available.

Full Answer

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.

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.

What is Railroad Retirement Medicare?

  • You’re automatically enrolled in Medicare at age 65 if you’re receiving RRB benefits. ...
  • Your monthly premium will be automatically deducted from your RRB payment — no bill to keep track of each month.
  • You’ll contact your RRB office for help instead of the local Medicare office. ...

What are the benefits of railroad retirement?

How do I verify Railroad Medicare eligibility?

  • Provider Contact Center: 888-355-9165.
  • IVR: 877-288-7600.
  • TTY: 877-715-6397.

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How do I verify eligibility for railroad Medicare?

Verifying Railroad Medicare enrollment is easy using our online PTAN Lookup and Request Tool. This tool first validates the provider identification information you enter — local Part B MAC PTAN, National Provider Identifier (NPI) and Tax Identification Number (TIN) — against enrollment information in our files.

How do I check 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.

Is railroad Medicare same as 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 bill railroad Medicare claims?

Getting Started With Railroad Medicare BillingStep 1: Ensure your enrollment information is correct with your local Part B Medicare Administrative Contractor (MAC) ... Step 2: Request a Railroad Medicare PTAN. ... Step 3: Receive your Railroad Medicare PTAN. ... Step 4: File Electronically. ... Step 5: Go Green — Electronic Remits.

How do I contact railroad Medicare?

Contact Railroad MedicareProvider Contact Center: 888-355-9165.IVR: 877-288-7600.TTY: 877-715-6397.

Does railroad Medicare have a provider portal?

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.

Does railroad Medicare follow Medicare guidelines?

(Although the age requirements for some unreduced railroad retirement benefits have risen just like the social security requirements, beneficiaries are still eligible for Medicare at age 65.)...Search.toll free:1-800-MEDICARE (1-800-633-4227)TTY/TDD:1-877-486-2048website:MEDICARE.govJan 14, 2022

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 is the payer ID for railroad Medicare?

MR018Payer Name: Medicare - Railroad|Payer ID: MR018|Professional (CMS 1500)

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. The second, fifth, eighth and ninth characters will always be a letter.

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.

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.

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.

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 ...

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.

How long do you have to enroll in Medicare if you have end stage renal disease?

Whether you become eligible for Medicare via age or disability, you’ll have seven months, called your Initial Enrollment Period (IEP), in which to enroll.

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.

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 happens 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. After the RRB automatically enrolls you, you receive your Medicare card together with a letter from the RRB explaining ...

What is the RRB?

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, ...

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 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.

What Medicare Parts does RRB automatically enroll you in?

If you are receiving Railroad Retirement benefits or railroad disability annuity checks when you become eligible for Medicare, RRB should automatically enroll you in Medicare Parts A and B . You should receive your red, white, and blue Medicare card and a letter from RRB explaining that you have been enrolled in Medicare.

What to do if you are not collecting Railroad Retirement?

If you are not collecting Railroad Retirement benefits when you turn 65, you should contact your local RRB field office to enroll in Medicare. If you are under 65 and have a disability, you will have to fulfill different eligibility requirements to qualify for Medicare.

Does Medicare Part B get deducted from your check?

If you receive Railroad Retirement benefits or railroad disability annuity checks, your Medicare Part B premium should be automatically deducted from your check each month. If you do not qualify for premium-free Part A, it will also be deducted from your check.

What age can I retire from railroads?

All railroad retirement beneficiaries age 65 or over and other persons who are directly or potentially eligible for railroad retirement benefits are covered by the program. Although the age requirements for some unreduced railroad retirement benefits have risen just like the social security requirements, beneficiaries are still eligible ...

When can I get Medicare if I have occupational disability?

If receiving benefits due to occupational disability and the person has not been granted a disability freeze, he or she is generally eligible for Medicare 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.

How long does a disabled employee have to be on Social Security?

Coverage before age 65 is available for disabled employee annuitants who have been entitled to monthly benefits based on total disability for at least 24 months and have a disability insured status under social security law.

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] .

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