Archive for the ‘Healthcare’ Category

RRB: Medicare Part B premiums for 2022

The Centers for Medicare & Medicaid Services (CMS) has announced that the standard monthly Part B premium will be $170.10 in 2022, an increase of $21.60 from $148.50 in 2021. Some Medicare beneficiaries may pay less than this amount because, by law, Part B premiums for current enrollees cannot increase by more than the amount of the cost-of-living adjustment for Social Security (Railroad Retirement Tier I) benefits.

Since the cost-of-living adjustment is 5.9% in 2022, some Medicare beneficiaries may see an increase in their Part B premiums but still pay less than $170.10. The standard premium amount will also apply to new enrollees in the program. However, certain beneficiaries will continue to pay higher premiums based on their modified adjusted gross income.

The monthly Part B premiums that include income-related adjustments for 2022 will range from $238.10 to $578.30, depending on the extent to which an individual beneficiary’s modified adjusted gross income exceeds $91,000 (or $182,000 for a married couple). The highest rate applies to beneficiaries whose incomes exceed $500,000 (or $750,000 for a married couple). CMS estimates that about 7% of Medicare beneficiaries pay the income-adjusted premiums.

Beneficiaries in Medicare Part D prescription drug coverage plans pay premiums that vary from plan to plan. Part D beneficiaries whose modified adjusted gross income exceeds the same income thresholds that apply to Part B premiums also pay a monthly adjustment amount. In 2022, the adjustment amount ranges from $12.40 to $77.90.

The Railroad Retirement Board withholds Part B premiums, Part B income-related adjustments and Part D income-related adjustments from benefit payments it processes. The agency can also withhold Part C and D premiums from benefit payments if an individual submits a request to his or her Part C or D insurance plan.

The following tables show the income-related Part B premium adjustments for 2022. The Social Security Administration (SSA) is responsible for all income-related monthly adjustment amount determinations. To make the determinations, SSA uses the most recent tax return information available from the Internal Revenue Service. For 2022, that will usually be the beneficiary’s 2020 tax return information. If that information is not available, SSA will use information from the 2019 tax return.

Railroad Retirement and Social Security Medicare beneficiaries affected by the 2022 Part B and D income-related premiums will receive a notice from SSA by the end of the year. The notice will include an explanation of the circumstances when a beneficiary may request a new determination. Persons who have questions or would like to request a new determination should contact SSA after receiving their notice.

Additional information about Medicare coverage, including specific benefits and deductibles, can be found at www.medicare.gov.


2022 Part B Premiums

Beneficiaries who file an individual tax return with income:Beneficiaries who file a joint tax return with income:Income-related monthly adjustment amountTotal monthly Part B premium amount
Less than or equal to $91,000Less than or equal to $182,000$0.00$170.10
Greater than $91,000 and less than or equal to $114,000Greater than $182,000 and less than or equal to $228,000$68.00$238.10
Greater than $114,000 and less than or equal to $142,000Greater than $228,000 and less than or equal to $284,000$170.10$340.20
Greater than $142,000 and less than or equal to $170,000Greater than $284,000 and less than or equal to $340,000$272.20$442.30
Greater than $170,000 and less than $500,000Greater than $340,000 and less than $750,000$374.20$544.30
$500,000 and above$750,000 and above$408.20$578.30

The monthly premium rates paid by beneficiaries who are married, but file a separate return from their spouses and who lived with their spouses at some time during the taxable year, are different. Those rates are as follows:

Beneficiaries who are married, but file a separate tax return, with income: Income-related monthly adjustment amountTotal monthly Part B premium amount
Less than or equal to $91,000$0.00$170.10
Greater than $91,000 and less than $409,000$374.20$544.30
$409,000 and above$408.20$579.30

ERMA Lifetime Maximum Benefit to increase in 2022

The lifetime maximum benefit for the Railroad Employees National Early Retirement Major Medical Benefit (ERMA or GA-46000) Plan will increase from $175,700 to $182,700 beginning Jan. 1, 2022.

At the end of 2001, labor and management had agreed on various procedures to administer the annual changes in the amount of the lifetime maximum benefit under the ERMA Plan.

In conjunction with the formula established in 2001, a new lifetime maximum was calculated by utilizing the October 2021 consumer price index (CPI) data for Hospital and Related Services and Physician Services. The result is a lifetime maximum for 2022 of $182,700.

For individuals who have reached the lifetime maximum, the incremental maximum available is applied to eligible expenses submitted for dates of service on or after the effective date of the new maximum. For 2022, this amount will be $7,000.

This change will apply to all railroads and crafts participating in ERMA.

Rail workers’ right to choose medical network upheld

In early July 2020, just over eight months after the current round of national bargaining had begun, the carriers’ representative — the National Railway Labor Conference (NRLC) — proposed reconfiguring the National Plan’s network structure in a way that would force many railroad workers into the cheapest area medical network immediately and then on a continual 3- to 5-year schedule without formal bargaining.

The Cooperating Railway Labor Organizations (CRLO), which is the rail labor umbrella group that oversees plan administration in concert with the NRLC, rejected the proposal, stating that this was an issue for negotiations and pointing out that the carriers had made an identical proposal at the bargaining table. In late July, the NRLC demanded that the unions agree to the proposal and threatened to use the binding deadlock neutral process found in the 1991 National Agreement settlement to resolve the dispute.

This threat led 12 unions in the CRLO to file suit against the nation’s Class I railroad carriers in the United States District Court for the District of Columbia, asking the court to force the carriers to bargain in good faith with the unions over mandatory subjects of bargaining, such as their network structure proposal. The carriers’ defense was that this was a “minor” dispute under the Railway Labor Act, as it involved an administrative matter under the National Plan and, therefore, could be resolved by the “deadlock neutral” process that was included in national agreements for all unions that were imposed by Congress — and signed into law by President George H. W. Bush — in order to stop a national strike in 1991.

At an Aug. 31, 2021, hearing before a Special Board of Adjustment chaired by Arbitrator Joshua M. Javits, the unions documented the history of health care network development in the railroad industry, showing that the carriers’ proposal was anything but administrative in nature. They also showed the adverse impact the proposal would have on over a quarter-million plan participants. The carriers countered that no “right to choose” existed in any national agreement, and that the deadlock neutral had the authority to decide the matter if the parties couldn’t agree.

In upholding the unions’ position on the key question of network choice, Chairman Javits’ Oct. 20 award found “that the Carriers’ proposal – in as far as it relates to the selection of network vendors – is an administrative matter. However, those elements of the Carriers’ proposal that reduce choice for Plan participants and result in only a single network vendor being available to Plan participants, constitutes a change in Plan design and, thus, is outside the deadlock neutral’s jurisdiction.”

The leaders of the prevailing unions issued the following statement concerning this decision:

“This is a significant victory for the men and women covered by the national plans, and for their families. The carriers have been dragging their feet at the bargaining table while this dispute wound its way through the system. All the while, our members — essential employees, one and all — have continued to keep the country moving despite the pandemic.

“To the carriers, whose profits continued to flow in unabated, we say ‘The time for delay is over. Your workers have earned and deserve a new national agreement, one that reflects their true contribution to your bottom line.’ We remain ready to negotiate that agreement, and urge you to devote as much energy to that task as you invested in your failed effort to deprive your workers of their choice of medical networks.”

# # #

The unions involved in the dispute are the American Train Dispatchers Association; the Brotherhood of Locomotive Engineers and Trainmen; the Brotherhood of Maintenance of Way Employes; the Brotherhood of Railroad Signalmen; the International Association of Machinists and Aerospace Workers; the International Association of Sheet Metal, Air, Rail and Transportation Workers, Mechanical Division; the International Association of Sheet Metal, Air, Rail and Transportation Workers, Transportation Division; the International Brotherhood of Boilermakers; the International Brotherhood of Electrical Workers; the National Conference of Fireman & Oilers District, Local 32BJ, SEIU; the Transportation Communications Union/IAM; and the Transport Workers Union.

View this release in PDF form.

SMART-TD responds to carrier vaccine mandates

Ferguson

Recently, Amtrak, Union Pacific and Norfolk Southern announced that they will require their employees, including those represented by SMART Transportation Division, to be vaccinated against the COVID-19 virus. It is anticipated that many of the remaining, if not all Class I rail carriers, will eventually implement similar policies, citing their status as government contractors and federal mandates as their reasons. In accordance with current guidelines, the deadline for Amtrak employees to be fully vaccinated is November 22, while the deadline for Union Pacific and Norfolk Southern employees is set for December 8. In order to be considered fully vaccinated, a 14-day period must transpire following the administration of the single-dose Johnson & Johnson vaccine, or the second dose of the Pfizer or Moderna vaccines.

Under certain circumstances, some carriers are allowing regular testing as an alternative to vaccination, although federal law, guidelines and most collective bargaining agreements do not require them to do so. SMART-TD has taken the position that beyond the applicable deadlines, all carriers should allow unvaccinated employees to provide proof of regular testing as an acceptable alternative.

In every instance to date, the carriers implemented their policies without first meeting with SMART-TD to bargain over the provisions of their mandates. In attempts to correct and address these exclusions, SMART-TD President Jeremy Ferguson advised all SMART-TD general committees of adjustment to schedule meetings with the carriers to discuss the implementation of any new, planned or existing policies. In his letter, he also noted that federal law provides exemptions for certain circumstances where individuals have religious objections or medical conditions that prevent them from being vaccinated. Based on initial conversations, it was determined that additional methods of appeal would be required.

Due to the unilateral actions of Union Pacific, on October 15, 2021, SMART-TD filed a lawsuit in the United States District Court for Northern District of Illinois, Eastern Division, challenging the carrier’s attempt to avoid its obligation under the Railway Labor Act to bargain over terms and conditions of employment. While this action at Union Pacific is likely to set precedent for other carriers, it does not prevent SMART-TD from taking similar action against other like-minded carriers, including Amtrak and Norfolk Southern. While each policy will have nuances that the affected organizations will have to navigate, respond to, and appeal on an individual basis, SMART-TD has made it clear that any attempt by the carriers to circumvent their obligations under the Railway Labor Act will be met with strong resistance.

“While vaccinations are not a collective bargaining issue, as they have not been negotiated into our agreements, we still believe that the carriers must engage with us about these policies prior to any implementation and we, in an effort of good faith, will continue our attempts to do so. We believe this is the best approach,” said President Ferguson. “We are going to let the outcome of those meetings and the advice of our general chairpersons guide our next steps. However, when these conversations with the carriers prove to be unsuccessful, then we must appeal our issues to the courts.”

President Ferguson also stated “SMART-TD is a very diversified union, encompassing members of different ethnicity, age, religion, gender, sexual orientation, political affiliation and viewpoints. We are proud of that diversity and represent all members regardless of these distinctions. We lead from the front, keeping emotions in check while evaluating every issue and concern along the way. We also must research the potential outcome of these actions prior to making any formal decisions. With that being said, I will continue to encourage our members to get vaccinated, however, I respect those who have pointed out that it is a personal choice. Whatever your beliefs or vaccine status is, I want to make it clear to our members that you will be represented to the fullest extent of our authority.”

As additional information becomes available and this situation continues to evolve, SMART-TD will continue to evaluate and assess its position on these issues. Updates will continue to be posted to the SMART-TD website at www.smart-union.org/td.

Medicare’s 2022 open enrollment period: October 15 – December 7, 2021

October marks the beginning of Medicare’s open enrollment period for the 2022 coverage year. If you already have Railroad Medicare and want to make a change to your Part D coverage or plan, you can do so between October 15 and December 7, 2021. Any changes you make during open enrollment will take effect January 1, 2022.

This period is the time to reflect on any changes that may have occurred this year, as well as the time to do a little research. You can do this on your own online, but also with a friend you didn’t know you had.

The most common change people face each year is a change to their prescription medicines, either the medicines themselves or the dosages. Be sure to check your plan’s drug formulary, which you should receive in the mail prior to October 15. You can compare available Part D drug plans using the “Find a Medicare plan” online tool at https://www.medicare.gov/plan-compare.

Other changes can be in the types of services that you need. Some may not be covered or covered by Medicare at the same rate as in 2021. You can research this when you receive your Medicare & You Handbook (by mail for some, online for those who have chosen to go paperless). Read the handbook carefully. There is a section called “What’s new & important” that will tell you the most critical things you need to know. The book also explains the different parts of Medicare, including what each part covers. Railroad Medicare is Part B (Medical Insurance) for persons covered under the railroad retirement system.

If you would like to see the Medicare & You Handbook now, you can do so by following this web address: https://www.medicare.gov/Pubs/pdf/10050-Medicare-and-You.pdf.

As for the “friend you didn’t know you had” … sometimes it’s hard to know what type of coverage you need or where to go to look and see what options you have. If this is you, then look no further than your state’s health insurance program. Every state has one, and they are manned by volunteers who have no affiliation with any health insurance programs (including Medicare). Visit the State Health Insurance Assistance Program website at https://www.shiphelp.org/ to find the phone number and website for your local SHIP.

The Railroad Retirement Board has released 2022 Medicare premium information.

In closing, if you have questions about SHIP or your Part B Railroad Medicare coverage, you can call Palmetto GBA’s toll-free Beneficiary Customer Service Line at 800-833-4455, 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.

We encourage you to visit Palmetto’s Facebook page at https://www.facebook.com/myrrmedicare. Palmetto GBA also invites you to join their email updates list. Just select the ‘Email Update’ link at the top of their main webpage at www.PalmettoGBA.com/RR/Me.


Palmetto GBA is the Railroad Specialty Medicare Administrative Contractor (RRB SMAC) and processes Part B claims for Railroad Retirement beneficiaries nationwide. Palmetto GBA is contracted by the independent federal agency Railroad Retirement Board (RRB), which administers comprehensive retirement-survivor and unemployment-sickness benefit programs for railroad workers and their families under the Railroad Retirement and Railroad Unemployment Insurance Acts.

Palmetto GBA: Let’s talk about mental health during the pandemic

Mental health is one of those things that we don’t want to talk about too much. With so much still unknown about the coronavirus, many people are still depressed, anxious, scared and stressed. We’ve watched how the world has changed during the pandemic, with millions of people losing their lives, and there is still a stigma related to the virus. Wear a mask. Don’t wear a mask. In the beginning, the coronavirus was thought to only affect the elderly population, but now, a year later, we know that to be untrue. Isolation, food and supply shortages were all things we dealt with during the pandemic.

Now the world is starting to open back up after more than a year of being isolated from families and friends. Many people are asking, “How do we ever get back to being normal?” One thing we can do is get vaccinated. Vaccines are now available to all people over the age of 12, and they are reducing the number of COVID-19 deaths and severe illnesses. In fact, 79.5% of those fully vaccinated are people 65 years or older. The COVID-19 vaccine is free to all Medicare beneficiaries.

Even though the pandemic is not over, (with the Delta variant a new concern) it is under better control. Americans are starting to travel again, see family and attend events with larger crowds. While these are good things, some of this news can cause many people to feel overwhelmed. According to the Centers for Disease Control and Prevention (CDC), “It is natural to feel stress, anxiety, grief and worry during the COVID-19 pandemic.”

Below are ways that you can help yourself, others and your community manage stress:

  • Turn the TV off. Reduce exposure to news stories, which can trigger stress.
  • Eat healthy, go for a walk and get plenty of sleep.
  • Find a new hobby or make time to do an old one.
  • Connect with others either in person or by phone.
  • Connect with your community or faith-based organizations. (CDC, 2021)

While we all wait for the World Health Organization to declare the COVID-19 pandemic over, we must still take proper precautions to ensure safety. If you are unvaccinated, according the CDC, you will still need to wear your mask. Seeing others not wearing a mask may also be stressful because you can’t be sure they are vaccinated.

If you are having trouble managing your feelings or not feeling like yourself, see your doctor or other approved healthcare provider and tell them how you are feeling. Don’t wait until your next annual wellness visit. Even if you don’t feel up to (or ready to face) getting out for a visit, many doctors today are offering telehealth visits. Some Medicare benefits you may not know of include:

  • Yearly depression screening
  • Diagnostic testing
  • Family counseling
  • Psychiatric evaluation
  • Individual and group psychotherapy
  • Medication management
  • Annual wellness visit
  • Caregiver-focused behavioral health risk assessment of their own behavior and health risks, which benefits the patient
  • Cognitive assessment and care planning
  • Drug therapy
  • Drug withdrawal treatment and other substance use disorder treatments
  • Hypnotherapy
  • Initial Preventive Physical Examination (IPPE) to review medical and social health history and provide preventive services education

For more information about your Medicare benefits and how they can help you get help when you’re feeling down, please call Palmetto GBA’s beneficiary contact center at 800-833-4455, Monday through Friday, from 8:30 a.m. to 7 p.m. ET. You are also encouraged to sign up for Palmetto’s email updates. To do so, click “Email Updates” on the top banner on the Palmetto GBA website at www.PalmettoGBA.com/RR/Me to start the process.

If you’d like to read more about the CDC and its information on coping with stress related to the coronavirus, please visit their website: https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/managing-stress-anxiety.html


Palmetto GBA is the Railroad Specialty Medicare Administrative Contractor (RRB SMAC) and processes Part B claims for Railroad Retirement beneficiaries nationwide. Palmetto GBA is contracted by the independent federal agency Railroad Retirement Board (RRB), which administers comprehensive retirement-survivor and unemployment-sickness benefit programs for railroad workers and their families under the Railroad Retirement and Railroad Unemployment Insurance Acts.

Palmetto GBA: Performing a cognitive assessment

Do you or a loved one have any of the following symptoms?

It’s easy to forget where you put your car keys once in a while. But if you or a loved one have any of the following problems, please read further:

  • Trouble remembering
  • Difficulty learning new things
  • Feeling overwhelmed making decisions
  • Getting confused easily or frequently
  • Becoming very impulsive or showing poor judgment

You might think your memory has “slipped,” but it might be more than that. Medicare offers a service to test your cognitive functioning. It’s called a cognitive assessment, and it can be performed when you see your provider for a visit. Many times, it is performed when you do your yearly wellness visit, but it can be performed at any time you have a concern.

It’s really helpful if you bring someone with you to that visit, such as a friend, spouse or caregiver, so that they can provide answers to questions you might not know the answers to. During the visit, your doctor will do the following:

  1. Perform a cognitive exam.
  2. Review your medical history and your medication. Sometimes medications can have side effects that may make you appear to have a cognitive impairment.
  3. Develop a plan of care, if one is needed.
  4. Make a referral to a specialist, if one is needed.
  5. Talk to you about community resources (these can include adult daycare, rehabilitation services, and more).

When this service is performed, the Part B deductible and coinsurance apply.

Cognitive impairment doesn’t always present in the ways noted above. It can also show up as depression, anxiety, apathy or irritation/aggression. If you see these in yourself or others, please make an appointment with your doctor. Having mild cognitive impairment can increase your risk of developing dementia caused by Alzheimer’s. Per the Mayo Clinic, “some people with mild cognitive impairment never get worse, and a few eventually get better.” Be the one who gets better. Call your doctor today.

If you need help locating a doctor, you can call our Palmetto GBA’s Beneficiary Contact Center at 800-833-4455, Monday through Friday, from 8:30 a.m. to 7 p.m. ET. You are invited to use Palmetto’s free internet portal, MyRRMed, to access claim status, historical Medicare Summary Notices, and review any individuals you have authorized to have access to your private medical information. You can visit MyRRMed at www.PalmettoGBA.com/MyRRMed.

We also encourage you to visit the Mayo Clinic website, which discusses mild cognitive impairment (MCI) here: https://www.mayoclinic.org/diseases-conditions/mild-cognitive-impairment/symptoms-causes/syc-20354578.

You can also access the Alzheimer’s Association website, which discusses cognitive assessment services, by visiting here: https://www.alz.org/professionals/health-systems-clinicians/cognitive-assessment.


Palmetto GBA is the Railroad Specialty Medicare Administrative Contractor (RRB SMAC) and processes Part B claims for Railroad Retirement beneficiaries nationwide. Palmetto GBA is contracted by the independent federal agency Railroad Retirement Board (RRB), which administers comprehensive retirement-survivor and unemployment-sickness benefit programs for railroad workers and their families under the Railroad Retirement and Railroad Unemployment Insurance Acts.

Palmetto GBA: A reminder on annual wellness visits for retirees

Medicare pays for an Annual Wellness Visit (AWV). It’s an awesome free preventive service that so many Medicare patients have not been taking advantage of. Since the onset of COVID-19, the number of AWVs being performed has fallen drastically, as many people have chosen to put off elective services. However, it’s important for you to do what is best for your health. That also means it may be best to take the time to have this service. If you talk to your healthcare provider and they say that it’s safe for you to have an AWV, then it makes sense to consider doing so.

First off, what is an AWV?

An Annual Wellness Visit is a visit to develop or update a preventive services plan that is personalized to your needs and to perform a Health Risk Assessment (HRA). An AWV comes in two sizes: your initial AWV and your follow-up AWV. Your initial AWV sets the baseline for future visits. Before or during this visit, you will complete a Health Risk Assessment (HRA) questionnaire, which will collect at a minimum:

  1. Your demographic data and a health status self-assessment
  2. Your assessment of depression/life satisfaction, stress, anger, pain, fatigue, isolation or loneliness
  3. Information on behavioral risks, including, but not limited to, if you smoke or use tobacco products, drink alcohol or use drugs, your physical activity and your nutrition
  4. Information on your ability to do general activities of daily living, such as washing clothes, bathing, walking, ability to stand for periods of time, etc.

During an initial AWV, your provider will create a baseline of your medical and family history, capture information about your current list of doctors and medications that you take, and gather measurements of your height, weight, blood pressure and other routine measurements as they apply based on your medical and family history. Your provider may also perform a cognitive impairment assessment to check for Alzheimer’s disease or dementia, and for depression and other mood disorders.

Your healthcare provider will review all of the information you provided to them, along with what they have observed focusing on your ability to do general activities of daily living, your risk of falling, plus any hearing impairments or potential home safety issues that may come up during the visit.

From all of this, your provider will create a written schedule/checklist, for the next five to 10 years for future screening visits and preventive services. Your provider will also give you personalized referrals for health education, preventive programs or counseling services based on what the AWV data has shown them.

These recommended services or programs can help you reduce risk factors or promote wellness, such as increasing weight loss and physical activity, as well as preventing falls and improving your nutrition. Referrals can be made for programs to help you quit smoking. You can also work with your provider to produce Advanced Care Planning documents such as living wills, advanced directives and other documents that instruct others about your healthcare wishes in the event you are unable to do so due to injury or illness.

That’s the first AWV. The second type of AWV is considered a follow-up AWV, or just a plain AWV.

At this AWV visit, you will review and update your HRA and your provider will update your medical/family history, the list of your current providers and medications and your measurements – including weight and blood pressure. Your provider will then make any needed changes to your screening schedule and your personalized health plan, and make new referrals, if necessary, to keep current with your needs. It is important to have this service every year. Your body is constantly changing – every day, every week, every month, every year. You take care of your plants, your car, your family, and you need to remember to take care of yourself as well.

How often can you get an AWV?

You can receive an AWV if:

  • It has been more than 12 months since the effective date of your first Medicare Part B coverage period, and
  • You have not received an Initial Preventive Physical Examination (IPPE, or “Welcome to Medicare” exam ) or an AWV within the past 12 months.

Where can I get an AWV?

Many healthcare providers are authorized to perform AWV services. They include:

  • Doctors of Medicine (MD) or Osteopathy (MO)
  • Physician’s assistant (PA), nurse practitioner (NP), or clinical nurse specialist (CNS)
  • A medical professional (including a health educator, registered dietitian, nutrition professional or other licensed practitioners) or a team of medical professionals working under the direct supervision of a physician.
  • Teaching physicians in graduate medical education programs can perform these services in certain specific circumstances.

If you have a question about the AWV, please call Palmetto GBA’s toll-free Beneficiary Contact Center at 800-833-4455, from 8:30 a.m. until 7 p.m. ET Monday through Friday. They offer a TTY/TDD line at 877-566-3572. This line is for the hearing impaired with the appropriate dial-up service and is available during the same hours as customer service representatives are available. Palmetto’s website is www.PalmettoGBA.com/RR/Me, and offers access to a free self-service internet portal, MyRRMed. MyRRMed offers you access to your healthcare data.

At this time, you can use the portal to access:

  • Status and details of your Railroad Medicare Part B claims;
  • Historical Medicare Summary Notices (MSNs) for your Railroad Medicare Part B claims;
  • A listing of individuals you have authorized to have access to your private health information; and
  • You can also submit a request to add an authorized representative or to edit or remove an existing authorized representative.

To sign up for MyRRMed, visit www.PalmettoGBA.com/MyRRMed.

Palmetto GBA: Details about the coronavirus vaccines

While we are coming up to the one-year anniversary of the coronavirus being present in the United States, we are happy to report that Medicare is taking action with the administration of the coronavirus vaccine across the country.

As the vaccinations roll out, we are receiving questions about the process, and we would like to share them and the answers with you. They are:

What does the vaccine cost?

The vaccine is free. Medicare will pay your provider for administering the vaccine, and you will not be charged in any way. If a provider tries to collect co-pays or any other types of funds specific to the coronavirus vaccine (such as coinsurances or deductibles), please call our office and let us know.

How is the vaccine being distributed?

Every state has its own vaccine distribution plan, and you can access that information from each state’s health department. To find a listing of states and their health departments, their websites and phone numbers, please see the article “What You Don’t Know May Make A Difference” on the Palmetto GBA website at www.PalmettoGBA.com/RR/Me. You can also find a listing on the Centers for Disease Control and Prevention (CDC) website at www.CDC.gov.

Where can I find out more about the individual vaccines?

There are two vaccines being used. They are Pfizer-BioNTech COVID-19 vaccine and Moderna’s COVID-19 vaccine​​. Additionally, per the CDC, there are three large-scale (Phase 3) clinical trials in progress or being planned for three COVID-19 vaccines:

AstraZeneca’s COVID-19 vaccine

Janssen’s COVID-19 vaccine

Novavax’s COVID-19 vaccine​

As each vaccine is approved and authorized, the CDC publishes information on who should or should not receive that particular vaccine based on health profiles. Additionally, the CDC will publish information to include the vaccine’s ingredients, its safety and its effectiveness. This information is located on the CDC website at www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines.html.

Can I get my shot sooner if I pay for that?

The vaccine is available based on each state’s distribution program. If someone contacts you and tells you that you can pay to either have your name put on a list to receive the vaccine (when you were not on the list yet to receive the shot) or tells you that you can pay to receive the vaccine sooner than you are scheduled for, do not believe them. These “opportunities” do not exist. And as always, do not share your personal and financial information with people who call, text or email you with any offer like this. Keep your private information private. The government will never call you and ask you for money.

If you have a question about Medicare’s coverage of the coronavirus vaccine, please call Palmetto GBA’s Beneficiary Contact Center at 800-833-4455, or for the hearing impaired, call TTY/TDD at 877-566-3572. Customer service representatives are available Monday through Friday, from 8:30 a.m. until 7 p.m. ET.

You are encouraged to visit the Palmetto GBA website at www.PalmettoGBA.com/RR/Me, as well as enrolling to use their free self-service internet portal, MyRRMed. MyRRMed offers you access to your healthcare data. At this time, you can use the portal to access:

  • Status and details of your Railroad Medicare Part B claims
  • Historical Medicare Summary Notices (MSNs) for your Railroad Medicare Part B claims
  • A listing of individuals you have authorized to have access to your private health information.
  • You can also submit a request to add an authorized representative or to edit or remove an existing authorized representative.

To sign up for MyRRMed, please visit the site at www.PalmettoGBA.com/MyRRMed.


Palmetto GBA is the Railroad Specialty Medicare Administrative Contractor (RRB SMAC) and processes Part B claims for Railroad Retirement beneficiaries nationwide. Palmetto GBA is contracted by the independent federal agency Railroad Retirement Board (RRB), which administers comprehensive retirement-survivor and unemployment-sickness benefit programs for railroad workers and their families under the Railroad Retirement and Railroad Unemployment Insurance Acts.

CDC order requires masks on all public transportation to slow COVID’s spread

The Centers for Disease Control and Prevention (CDC) issued an order Jan. 29 imposing a mask requirement applicable to public transportation systems, rail, and van, bus and motorcoach service providers to mitigate the risk of the spread of COVID-19.

The order implements President Joe Biden’s Executive Order 13998, Promoting COVID-19 Safety in Domestic and International Travel, “to save lives and allow all Americans, including the millions of people employed in the transportation industry, to travel and work safely.”

In an announcement of the order sent to Federal Railroad Administration stakeholders and partners on Jan. 31, an agency representative wrote the following: “Science-based measures are critical to preventing the spread of COVID-19. Mask-wearing is one of several proven life-saving measures including physical distancing, appropriate ventilation and timely testing that can reduce the transmission of COVID-19. Requiring masks will protect America’s transportation workers and passengers, help control the transmission of COVID-19, and aid in re-opening America’s economy.”

In addition to the CDC order, the Transportation Security Administration (TSA) anticipates issuing additional information and guidance.

The U.S. Department of Transportation has posted a web page answering Frequently Asked Questions regarding COVID safety.

DOT will continue to add additional information to the site in the coming days and will be scheduling stakeholder calls beginning this week.

Questions regarding the mask mandate can be sent to the Federal Railroad Administration at RailroadsMaskUp@dot.gov.

VSTD waiver of elimination period extended through February 2021

The SMART Voluntary Short Term Disability Plan (VSTD) has temporarily suspended the elimination period for COVID-19 disabilities. Previously, the waiver of the elimination period began in the month of March and extended through May of this year and then was once again extended until November 2020.

SMART, in conjunction with Southern Benefit Administrators, is pleased to announce that the waiver of the elimination period is being extended through February 28, 2021. Effective with all diagnosed COVID-19 disabilities beginning in the months of March 2020 through February 2021, the Plan’s elimination period will be waived. A member must usually be disabled for 21 days before benefits will begin on the 22nd day. With the waiver of the elimination period, members who have tested positive for COVID-19 will have earlier access to benefits.

The waiting period will be reinstated for COVID-19 disabilities beginning on or after March 1, 2021.

Click here for a pdf of this announcement.

ERMA lifetime maximum benefit to increase in 2021

The lifetime maximum benefit for the Railroad Employees National Early Retirement Major Medical Benefit (ERMA or GA-46000) Plan will increase from $171,100 to $175,700 beginning Jan. 1, 2021.

At the end of 2001, labor and management had agreed on various procedures to administer the annual changes in the amount of the lifetime maximum benefit under the ERMA Plan.

In conjunction with the formula established in 2001, a new lifetime maximum was calculated by utilizing the October 2020 consumer price index (CPI) data for Hospital and Related Services and Physician Services. The result is a lifetime maximum for 2021 of $175,700.

For individuals who have reached the lifetime maximum, the incremental maximum available is applied to eligible expenses submitted for dates of service on or after the effective date of the new maximum. For 2021, this amount will be $4,600.

This change will apply to all railroads and crafts participating in ERMA.