Medicare for Railroad Families
Targeted News Service |
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.
* Medicare Part A (hospital insurance) helps pay for inpatient care in hospitals and skilled nursing facilities (following a hospital stay), some home health care services, and hospice care. Part A is financed through payroll taxes paid by employees and employers.
* Medicare Part B (medical insurance) helps pay for medically-necessary services like doctors' services and outpatient care. Part B also helps cover some preventive services. Part B is financed by premiums paid by participants and by Federal general revenue funds
* Medicare Part C (Medicare Advantage Plans) is another way to get
*
The following questions and answers provide basic information on
1. Who is eligible for
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 for
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. There is no 24-month waiting period for those who have ALS (Amyotrophic Lateral Sclerosis), also known as
If entitled to monthly benefits based on an occupational disability, and the individual has been granted a disability freeze, he or she is eligible for
Under certain conditions, spouses, divorced spouses, surviving divorced spouses, widow(er)s, or a dependent parent may be eligible for
2. How do persons enroll in
If a retired employee, or a family member, is receiving a railroad retirement annuity, enrollment for both Medicare Part A and Part B is generally automatic and coverage begins when the person reaches age 65. For beneficiaries who are totally and permanently disabled, both Medicare Part A and Part B start automatically with the 30th month after the beneficiary became disabled or, if later, the 25th month after the beneficiary became entitled to monthly benefits. Even though enrollment is automatic, an individual may decline Part B; this does not prevent him or her from applying for Part B at a later date. However, premiums may be higher if enrollment is delayed. (See question 5 for more information on delayed enrollment.)
If an individual is eligible for, but not receiving an annuity, he or she should contact the nearest Railroad Retirement Board (RRB) office before attaining age 65 and apply for both Part A and Part B. (This does not mean that the individual must retire, if presently working.) The best time to apply is during the 3 months before the month in which the individual reaches age 65. He or she will then have both Part A and Part B protection beginning with the month age 65 is reached. If the individual does not enroll for Part B in the 3 months before attaining age 65, he or she can enroll in the month age 65 is reached, or during the 3 months that follow, but there will be a delay of 1 to 3 months before Part B is effective. Individuals who do not enroll during this "initial enrollment period" may sign up in any "general enrollment period" (
3. Are there costs associated with Medicare Part A (hospital insurance)?
Yes. While individuals don't have to pay a premium to receive Medicare Part A, recipients of Part A benefits are billed by the hospital for a deductible amount (
4. What are the costs associated with Medicare Part B (medical insurance)?
Anyone eligible for
There is also an annual deductible (
Railroad Medicare Part B Office
P.O. Box 10066
1-800-833-4455
Persons with questions about Part B claims under the Original Medicare Plan can contact
5. Can Medicare Part B premiums increase for delayed enrollment?
Yes. Premiums for Part B are increased 10 percent for each 12-month period the individual could have been, but was not, enrolled. However, individuals age 65 or older who wait to enroll in Part B because they have group health plan coverage based on their own or their spouse's current employment may not have to pay higher premiums because they may be eligible for "special enrollment periods." The same special enrollment period rules apply to disabled individuals, except that the group health insurance may be based on the current employment of the individual, his or her spouse, or a family member.
Individuals deciding when to enroll in Medicare Part B must consider how this will affect eligibility for health insurance policies which supplement
6. What is Medigap insurance?
Many private insurance companies sell insurance, called "Medigap" for short, that helps pay for services not covered by the Original Medicare Plan. Policies may cover deductibles, coinsurance, copayments, health care outside
7. Do
Yes. Under the Original Medicare Plan, the fee-for-service
However, a beneficiary may opt to choose a Medicare Advantage Plan (Part C) instead. These plans are managed by
8. How do
The Affordable Care Act requires some Part D beneficiaries to also pay a monthly adjustment amount, depending on a beneficiary's or married couple's modified adjusted gross income. The Part D income-related monthly adjustment amounts in 2014 are
To enroll, individuals must have Medicare Part A and live in the prescription drug benefit plan's service area. Beneficiaries can join during the period that starts 3 months before the month their
9. Where can I get more information about the
Railroad retirement beneficiaries should contact the RRB toll-free at 1-877-772-5772 for general information on their
More detailed information on
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Copyright: | (c) 2014 Targeted News Service |
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