nd others, including annuity esti

nemployment applications and

Board’s Web site. The Web site

cations and information about many

ee Number and Web Site

ARE (1-800-633-4227)

D 1-877-486-2048

medicare.gov

edicare questions, you can call

or look on the Web site.

-Free Number and Web Site

00-833-4455

D 1-877-566-3572

almettogba.com

l Medicare Plan and have questions

urance (Part B) claims, you can call

mber or visit the Web site for help.

oard

2 

January 2007

MEDICARE 

For Railroad Workers and Their Families
misconduct by a Railroad Retirement Board employee.The Hot Line has been installed by the RailroadRetirement Board’s Inspector General to receive any evidence of such fraud or abuse of the Board’s benefit programs. The toll-free Hot Line number nationwide is 1-800-772-4258. Or you may send your complaints inwriting to RRB, OIG, Hot Line Officer, 844 North RushStreet, Chicago, Illinois 60611-2092 or via e-mail at hotline@oig.rrb.gov. Please do not call or write theInspector General’s Hot Line with questions about eligibility requirements, delayed payments, or similar problems.Such matters should be directed to the nearest RailroadRetirement Board office.

enefit programs for railroad 

s under the Railroad Retirement 

mployment Insurance Act. These 

 protection during old age and in 

ath or temporary unemployment 

ad Retirement Board also admin

care program and has administra

 the Social Security Act and the 

ssion, the Railroad Retirement 

fits to the right people, in the 

 manner, and will take appropri

r customers’ trust funds. The 

d will treat every person who 

he agency with courtesy and con

quiries promptly, accurately and 
by the Board on the basis of dis

n 90 days in writing with the

n, Railroad Retirement Board,

hicago, Illinois 60611-2092.

al rights under this regulation may

 Director of Equal Opportunity at

16

What is Medicare? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Who can get Medicare? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 How much does Medicare cost? . . . . . . . . . . . . . . . . . . . . . . 5 Signing up for Medicare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 If you have other health insurance . . . . . . . . . . . . . . . . . . . . . 10 Options for receiving health care services . . . . . . . . . . . . . . . 12 Medical insurance claims . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Medicare prescription drug plans . . . . . . . . . . . . . . . . . . . . . . 14 

More detailed information on Medicare’s benefits, costs, and 

health service options is available from the Centers for Medicare & Medicaid Services publication Medicare & You which is 

mailed to Medicare beneficiary households each fall and to new Medicare beneficiaries when they become eligible for the coverage. Medicare & You and other Medicare publications are also available by calling the Medicare toll-free number, 1-800-MEDICARE (1-800-633-4227), TTY/TDD 1-877-486-2048 or by going to www.medicare.gov on the Internet and clicking on “Find a Medicare Publication.” 

This booklet is issued for the purpose of 

general information. Certain limitations, 

exceptions and special cases are not covered. 

1
1-800-MEDICARE (1-800-633-4227) or by visitingwww.medicare.gov on the Internet and clicking on “Find a Medicare Publication.”

Need More Information?

Railroad retirement beneficiaries should contact the

nearest Railroad Retirement Board office for general information on their Medicare coverage. They can also use theBoard’s automated toll-free number and Web site, or theMedicare and Palmetto GBA information sources asdescribed on the back cover of this leaflet.

15

care & Medicaid Services (CMS) 

 the Medicare program. The 

d, however, enrolls railroad 

n the program, deducts Medicare 

benefit payments, and assists in 

 (also called Medicare Part A), 

ient care in hospitals and skilled 

ng a hospital stay), some home 

are. 

 (also called Medicare Part B), 

rs’ services, and many other 

plies that are not covered by hos

clude laboratory services, home 

spital services, blood and preven

rs. 

Coverage (also called Medicare 

more detail on pages 14-15. 

2
y pay a monthly premium (an

nd an annual deductible of up to

a share of your prescription drug

ng on the drug plan you choose.

e and your resources are less

person or $23,410 for a married

qualify for extra help to cover

come eligible for Medicare, they

prescription drug plan during the

s before the month their

and ends 3 months after that

 a drug plan when you are first

o pay a higher premium if you

erally join or change plans once

n enrollment period” from

cember 31. Drug coverage

 1 of the following year.

escription drug coverage from

overage provided by an employer

at coverage. If that coverage

benefits than a Medicare prescrip

ot have to pay a higher premium

14

WHO CAN GET MEDICARE? 

Hospital Insurance (Part A) 

If you are age 65 or older. Most people age 65 or 

older who are citizens or permanent residents of the United States are eligible for free Medicare hospital insurance (Part A). You are eligible at age 65 if you receive or are eligible to receive railroad retirement or social security benefits. (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.) 

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. If you are entitled to monthly benefits based on an occupational disability, and have been granted a disability freeze, you are eligible for Medicare hospital insurance 29 months after the freeze date. 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 

3
(Part B) claims for railroad retirement beneficiaries in theOriginal Medicare Plan. If you are in the OriginalMedicare Plan, your hospital, doctor, or other health careprovider should submit Part B claims directly to:

Palmetto GBA

Railroad Medicare Part B Office

P.O. Box 10066

Augusta, GA 30999-0001

If you have questions about Part B claims under the

Original Medicare Plan, write to Palmetto GBA at theabove address; telephone them toll-free at 1-800-833-4455,(TTY/TDD: 1-877-566-3572); or go towww.palmettogba.com on the Internet, click on “RailroadMedicare” under “Beneficiaries,” and select “Contact Us.”

For those in a Medicare Advantage Plan, information

on out-of-pocket costs is available by calling the Medicaretoll-free number 1-800-MEDICARE (1-800-633-4227) orby going to www.medicare.gov on the Internet and clicking on “Compare Health Plans and Medigap Policies inYour Area.”

13

y

 you are eligible for free 

ce at any age. This is true if you 

sis or a kidney transplant and 

 receiving monthly benefits under 

social security system. 

se, divorced spouse or child may 

 work record, if she or he has 

and receives maintenance dialy

 

art B) 

e for free Medicare hospital 

roll in Medicare medical insur

 monthly premium. While most 

thly premium of $93.50 in 2007, 

me beneficiaries are greater, 

y’s or married couple’s modified 

he income-related Part B premi

, $124.40, $142.90, or $161.40, 

o which an individual beneficia

000 (or a married couple’s 

), with the highest premium rates 

 whose incomes are over 

4 
g

g coverage. Or a beneficiary can

ntage Plan. These plans are

 the country. A beneficiary must

A and Part B to join a Medicare

ndividual must live in the plan’s

dvantage Plan choices include

er organizations (PPOs), health

s (HMOs), private fee-for-service

is a plan under which a benefici

s, and providers belonging to a

n use doctors, hospitals, and

work for an additional cost.

ge, a beneficiary may pay lower

xtra benefits. Most plans include

e.

rmation about your health care

on Medicare & You. This gener

le after they enroll in Medicare

 mailed each year after that.

12

In addition to the monthly premiums you pay, there are 

other out-of-pocket costs for Medicare, which may also change each year. These costs, known as “deductibles” and “coinsurance,” are the amounts you pay when you actually receive medical service. 

For example, if you are hospitalized, you will be 

required to pay a deductible amount, and may have to pay coinsurance amounts, depending on how long you stay. In 2007, the hospital insurance deductible amount is $992. 

If you receive medical services from a doctor, you pay 

a yearly deductible amount as well as a coinsurance amount for each visit. In 2007, the medical insurance deductible is $131. 

If you cannot afford to pay your Medicare premiums 

and other medical costs, you may be able to get help from your State. States offer programs for people who are entitled to Medicare and have low income. The State-run programs may pay some or all of Medicare’s premiums and may also pay Medicare deductibles and coinsurance. 

5
special enrollment period, and in most cases you won’t paya late enrollment penalty. Call the contractor that handlesTRICARE claims at 1-866-773-0404 or a military healthbenefits advisor for information before you decide whetherto enroll in Medicare medical insurance.

If you have health care protection from the Indian

Health Service, Department of Veterans Affairs or a Statemedical assistance program, contact the people in thoseoffices to help you decide whether it is to your advantageto have Medicare medical insurance.

For more information on how other health insurance

plans work with Medicare, call the Medicare toll-free number 1-800-MEDICARE (1-800-633-4227) and ask for thepublication Medicare and Other Health Benefits: YourGuide to Who Pays First. Or visit www.medicare.gov onthe Internet and click on “Find a Medicare Publication.”

11

UP FOR MEDICARE 

ting railroad retirement or 

ou will be contacted a few 

e eligible for Medicare and given 

dicare program. You will auto

Medicare Parts A and B. 

ust pay a premium for Part B cov

n of turning it down. 

 getting benefits, you should 

d Retirement Board office about 

h birthday to sign up for 

up for Medicare even if you don’t 

ct your local Board office about 

dow or widower between age 50 

plied for disability benefits 

tting another kind of benefit; 

medical insurance in the past but 

6 
swers, we can offer a few tips

 you make your decision.

ns

e agent to see how your private

edical insurance. This is espe

ve family members who are cov

y. And remember, just as

all health services, most private

anning your health insurance cov

most nursing home care is not

rivate health insurance policies.

ution: for your own protection,

 insurance you now have until

 actually begins.

roup Health Plans

 employers with 20 or more

y law to offer workers and their

or older) the same health benefits

ger employees.

10

age and result in higher premiums. If you are eligible at age 65, your initial enrollment period begins 3 months before your 65th birthday, includes the month you turn age 65, and ends 3 months after that birthday. If you are eligible for Medicare based on disability or permanent kidney failure, your initial enrollment period depends on the date your disability or treatment began. 

When does my 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. 

If you enroll in this 

month of your initial 

enrollment period: 

1, 2, 3

Then your 

Medicare Part B 

coverage starts: 

the month you become eligible for Medicare 

4 1 month after 

enrollment 

5 2 months after 

enrollment 

6, 7 3 months 

after enrollment 

7
vate insurance companies, that helps pay for some of thecosts that the Original Medicare Plan doesn’t pay for.

When an individual enrolls in Medicare Part B at or

after age 65, a one-time “Medigap open enrollment period”is triggered. The open enrollment period lasts for 6months. During this period, an insurance company can’tdeny insurance coverage, place conditions on a policy, orcharge more for a policy because of past or present healthproblems.

Individuals age 65 or older with health coverage

through an employer or union based on their or theirspouse’s current employment may want to wait to enroll inMedicare Part B and delay their Medigap open enrollmentperiod.

More detailed information about Medigap policies and

other supplemental health insurance plans is available inthe publication Choosing a Medigap Policy: A Guide toHealth Insurance for People with Medicare. To get a copy,call the Medicare toll-free number 1-800-MEDICARE (1-800-633-4227) or go to www.medicare.gov on theInternet and click on “Find a Medicare Publication.”

9

lder and are covered under a 

from your own or your spouse’s 

u have a “special enrollment peri

or Medicare Part B. This means 

ing in Medicare Part B without 

al enrollment period and paying 

urcharge for late enrollment. The 

Part B any time while you are 

health plan based on current 

Part B during the 8-month period 

h your group health coverage 

yment ends -- whichever comes 

riod rules do not apply if employ

ed group health plan coverage 

nrollment period. 

y the end of the 8-month period, 

l the next general enrollment 

ary 1 of the next year. 

8 
lder and are covered under a

from your own or your spouse’s

u have a “special enrollment peri

or Medicare Part B. This means

ing in Medicare Part B without

al enrollment period and paying

urcharge for late enrollment. The

Part B any time while you are

health plan based on current

Part B during the 8-month period

h your group health coverage

yment ends -- whichever comes

riod rules do not apply if employ

ed group health plan coverage

nrollment period.

y the end of the 8-month period,

l the next general enrollment

ary 1 of the next year.

8

vate insurance companies, that helps pay for some of the costs that the Original Medicare Plan doesn’t pay for. 

When an individual enrolls in Medicare Part B at or 

after age 65, a one-time “Medigap open enrollment period” is triggered. The open enrollment period lasts for 6 months. During this period, an insurance company can’t deny insurance coverage, place conditions on a policy, or charge more for a policy because of past or present health problems. 

Individuals age 65 or older with health coverage 

through an employer or union based on their or their spouse’s current employment may want to wait to enroll in Medicare Part B and delay their Medigap open enrollment period. 

More detailed information about Medigap policies and 

other supplemental health insurance plans is available in the publication Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare. To get a copy, call the Medicare toll-free number 1-800-MEDICARE (1-800-633-4227) or go to www.medicare.gov on the Internet and click on “Find a Medicare Publication.” 

9
age and result in higher premiums. If you are eligible atage 65, your initial enrollment period begins 3 monthsbefore your 65th birthday, includes the month you turn age65, and ends 3 months after that birthday. If you are eligible for Medicare based on disability or permanent kidneyfailure, your initial enrollment period depends on the dateyour disability or treatment began.

When does my 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 first3 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.

7

If you enroll in this Then your

month of your initial Medicare Part B 

enrollment period: coverage starts:

1, 2,

3 the month you

become eligible for Medicare

4 1 month after

enrollment

5 2 months after

enrollment

6, 7 3 months

after enrollment

swers, we can offer a few tips 

 you make your decision. 

ns 

e agent to see how your private 

edical insurance. This is espe

ve family members who are cov

y. And remember, just as 

all health services, most private 

anning your health insurance cov

most nursing home care is not 

rivate health insurance policies. 

ution: for your own protection, 

 insurance you now have until 

 actually begins. 

roup Health Plans 

 employers with 20 or more 

y law to offer workers and their 

or older) the same health benefits 

ger employees. 

10 
UP FOR MEDICARE

ting railroad retirement or

ou will be contacted a few

e eligible for Medicare and given

dicare program. You will auto

Medicare Parts A and B.

ust pay a premium for Part B cov

n of turning it down.

 getting benefits, you should

d Retirement Board office about

h birthday to sign up for

up for Medicare even if you don’t

ct your local Board office about

dow or widower between age 50

plied for disability benefits

tting another kind of benefit;

medical insurance in the past but

6

special enrollment period, and in most cases you won’t pay a late enrollment penalty. Call the contractor that handles TRICARE claims at 1-866-773-0404 or a military health benefits advisor for information before you decide whether to enroll in Medicare medical insurance. 

If you have health care protection from the Indian 

Health Service, Department of Veterans Affairs or a State medical assistance program, contact the people in those offices to help you decide whether it is to your advantage to have Medicare medical insurance. 

For more information on how other health insurance 

plans work with Medicare, call the Medicare toll-free number 1-800-MEDICARE (1-800-633-4227) and ask for the publication Medicare and Other Health Benefits: Your Guide to Who Pays First. Or visit www.medicare.gov on the Internet and click on “Find a Medicare Publication.” 

11
In addition to the monthly premiums you pay, there are

other out-of-pocket costs for Medicare, which may alsochange each year. These costs, known as “deductibles”and “coinsurance,” are the amounts you pay when youactually receive medical service.

For example, if you are hospitalized, you will be

required to pay a deductible amount, and may have to paycoinsurance amounts, depending on how long you stay. In2007, the hospital insurance deductible amount is $992.

If you receive medical services from a doctor, you pay

a yearly deductible amount as well as a coinsuranceamount for each visit. In 2007, the medical insurancedeductible is $131.

If you cannot afford to pay your Medicare premiums

and other medical costs, you may be able to get help fromyour State. States offer programs for people who are entitled to Medicare and have low income. The State-run programs may pay some or all of Medicare’s premiums andmay also pay Medicare deductibles and coinsurance.

5

g

g coverage. Or a beneficiary can 

ntage Plan. These plans are 

 the country. A beneficiary must 

A and Part B to join a Medicare 

ndividual must live in the plan’s 

dvantage Plan choices include 

er organizations (PPOs), health 

s (HMOs), private fee-for-service 

is a plan under which a benefici

s, and providers belonging to a 

n use doctors, hospitals, and 

work for an additional cost. 

ge, a beneficiary may pay lower 

xtra benefits. Most plans include 

e. 

rmation about your health care 

on Medicare & You. This gener

le after they enroll in Medicare 

 mailed each year after that. 

12
y

 you are eligible for free

ce at any age. This is true if you

sis or a kidney transplant and

 receiving monthly benefits under

social security system.

se, divorced spouse or child may

 work record, if she or he has

and receives maintenance dialy

art B)

e for free Medicare hospital

roll in Medicare medical insur

 monthly premium. While most

thly premium of $93.50 in 2007,

me beneficiaries are greater,

y’s or married couple’s modified

he income-related Part B premi

, $124.40, $142.90, or $161.40,

o which an individual beneficia

000 (or a married couple’s

), with the highest premium rates

 whose incomes are over

4

(Part B) claims for railroad retirement beneficiaries in the Original Medicare Plan. If you are in the Original Medicare Plan, your hospital, doctor, or other health care provider should submit Part B claims directly to: 

Palmetto GBA

Railroad Medicare Part B Office

P.O. Box 10066

Augusta, GA 30999-0001

If you have questions about Part B claims under the 

Original Medicare Plan, write to Palmetto GBA at the above address; telephone them toll-free at 1-800-833-4455, (TTY/TDD: 1-877-566-3572); or go to www.palmettogba.com on the Internet, click on “Railroad Medicare” under “Beneficiaries,” and select “Contact Us.” 

For those in a Medicare Advantage Plan, information 

on out-of-pocket costs is available by calling the Medicare toll-free number 1-800-MEDICARE (1-800-633-4227) or by going to www.medicare.gov on the Internet and clicking on “Compare Health Plans and Medigap Policies in Your Area.” 

13
WHO CAN GET MEDICARE?

Hospital Insurance (Part A)

If you are age 65 or older. Most people age 65 or

older who are citizens or permanent residents of the UnitedStates are eligible for free Medicare hospital insurance(Part A). You are eligible at age 65 if you receive or areeligible to receive railroad retirement or social securitybenefits. (Although the age requirements for some unreduced railroad retirement benefits have risen just like thesocial security requirements, beneficiaries are still eligiblefor Medicare at age 65.)

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 forat least 24 months. If you are entitled to monthly benefitsbased on an occupational disability, and have been granteda disability freeze, you are eligible for Medicare hospitalinsurance 29 months after the freeze date. If you receivebenefits due to occupational disability and have not beengranted a disability freeze, you are generally eligible forMedicare hospital insurance at age 65. (The standards fora disability freeze determination follow social security lawand are comparable to the medical criteria for granting

3

y pay a monthly premium (an 

nd an annual deductible of up to 

a share of your prescription drug 

ng on the drug plan you choose. 

e and your resources are less 

person or $23,410 for a married 

qualify for extra help to cover 

come eligible for Medicare, they 

prescription drug plan during the 

s before the month their 

and ends 3 months after that 

 a drug plan when you are first 

o pay a higher premium if you 

erally join or change plans once 

n enrollment period” from 

cember 31. Drug coverage 

 1 of the following year. 

escription drug coverage from 

overage provided by an employer 

at coverage. If that coverage 

benefits than a Medicare prescrip

ot have to pay a higher premium 

14 
care & Medicaid Services (CMS)

 the Medicare program. The

d, however, enrolls railroad

n the program, deducts Medicare

benefit payments, and assists in

(also called Medicare Part A),

ient care in hospitals and skilled

ng a hospital stay), some home

are.

 (also called Medicare Part B),

rs’ services, and many other

plies that are not covered by hos

clude laboratory services, home

spital services, blood and preven

rs.

Coverage (also called Medicare 

more detail on pages 14-15.

2

1-800-MEDICARE (1-800-633-4227) or by visiting www.medicare.gov on the Internet and clicking on “Find a Medicare Publication.” 

Need More Information? 

Railroad retirement beneficiaries should contact the 

nearest Railroad Retirement Board office for general information on their Medicare coverage. They can also use the Board’s automated toll-free number and Web site, or the Medicare and Palmetto GBA information sources as described on the back cover of this leaflet. 

15
What is Medicare? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2Who can get Medicare? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3How much does Medicare cost? . . . . . . . . . . . . . . . . . . . . . . 5Signing up for Medicare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6If you have other health insurance . . . . . . . . . . . . . . . . . . . . . 10Options for receiving health care services . . . . . . . . . . . . . . . 12Medical insurance claims . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13Medicare prescription drug plans . . . . . . . . . . . . . . . . . . . . . . 14

More detailed information on Medicare’s benefits, costs, and

health service options is available from the Centers for Medicare& Medicaid Services publication Medicare & You which is

mailed to Medicare beneficiary households each fall and to newMedicare beneficiaries when they become eligible for the coverage. Medicare & You and other Medicare publications are alsoavailable by calling the Medicare toll-free number, 1-800-MEDICARE (1-800-633-4227), TTY/TDD 1-877-486-2048 or by going to www.medicare.gov on theInternet and clicking on “Find a Medicare Publication.”

This booklet is issued for the purpose of 

general information. Certain limitations, 

exceptions and special cases are not covered.

1

by the Board on the basis of dis

n 90 days in writing with the 

n, Railroad Retirement Board, 

hicago, Illinois 60611-2092. 

al rights under this regulation may 

 Director of Equal Opportunity at 

16
enefit programs for railroad

s under the Railroad Retirement

mployment Insurance Act. These

 protection during old age and in

ath or temporary unemployment

ad Retirement Board also admin

care program and has administra

 the Social Security Act and the

ssion, the Railroad Retirement 

fits to the right people, in the

 manner, and will take appropri

r customers’ trust funds. The

d will treat every person who

he agency with courtesy and con

quiries promptly, accurately and

misconduct by a Railroad Retirement Board employee. The Hot Line has been installed by the Railroad Retirement Board’s Inspector General to receive any evidence of such fraud or abuse of the Board’s benefit programs. The toll-free Hot Line number nationwide is 1-800-772-4258. Or you may send your complaints in writing to RRB, OIG, Hot Line Officer, 844 North Rush Street, Chicago, Illinois 60611-2092 or via e-mail at hotline@oig.rrb.gov. Please do not call or write the Inspector General’s Hot Line with questions about eligibility requirements, delayed payments, or similar problems. Such matters should be directed to the nearest Railroad Retirement Board office. 
MEDICARE

For Railroad Workers and Their Families

nd others, including annuity esti

nemployment applications and 

Board’s Web site. The Web site 

cations and information about many 

ee Number and Web Site 

ARE (1-800-633-4227) 

D 1-877-486-2048 

medicare.gov 

edicare questions, you can call 

or look on the Web site. 

-Free Number and Web Site 

00-833-4455 

D 1-877-566-3572 

almettogba.com 

l Medicare Plan and have questions 

urance (Part B) claims, you can call 

mber or visit the Web site for help. 

oard 

2 

January 2007