If you are a railroad worker and get Medicare from the Railroad Retirement Board, your Medicare benefits will generally work the same way as for people who get Medicare through Social Security. There are just a few differences:

  • Your enrollment will be processed by the Railroad Retirement Board instead of by Social Security. If you are receiving railroad retirement benefits or railroad disability annuity checks when you become eligible for Medicare, the Railroad Retirement Board will automatically enroll you in Medicare Parts A and B. A few months before your Medicare eligibility begins, you will receive your Medicare card and a letter from the Railroad Retirement Board explaining that you have been enrolled in Medicare.If you qualify for railroad retirement benefits, but are not yet receiving them when you turn 65, you will need to contact your local Railroad Retirement Board 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. Whether you are eligible for Medicare and when you get it depend on how your disability has been classified by the Railroad Retirement Board.

    Note: If you get continuing dialysis for permanent kidney failure (End-Stage Renal Disease or ESRD), or you have had a kidney transplant, you should enroll in Medicare by contacting Social Security, even if you are a railroad worker.

  • The Railroad Retirement Board will collect your Medicare Part A premiums (if you have them) and Part B premiums. If you receive railroad retirement benefits or railroad disability annuity checks, your Medicare premiums will be automatically deducted from your check each month.
  • Your doctors and other health care providers will bill Medicare differently for services covered under Part B. Your providers must send Railroad Medicare Part B claims to the Part B carrier selected by the Railroad Retirement Board. To make sure that Medicare pays for your covered health services, always make sure your doctors and other health care providers know that you have Railroad Medicare, not Social Security Medicare.
  • Your Medicare card will look different:

    Railroad card
    • Your card will say Railroad Retirement Board instead of showing the phone number to call Social Security.
    • Your Medicare Claim Number will have a letter before your number, not after.
    • Your card will have the Railroad Retirement Board address on the back.