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The head-cold and flu season is upon us, making it time to lower your risk of disease and illness by receiving a flu shot and pneumonia vaccine – and if you or your spouse is covered by Medicare, you won’t bear the cost and do not require a doctor’s referral.

The flu shot is an annual event, as the flu vaccine is formulated each flu season for the most probable flu virus.

You may only reqire one pneumonia shot in your lifetime, and if you are at least 65, have a chronic illness such as diabetes, or have a heart or lung disease, your risk of contracting pneumonia is higher.

Health care providers suggest you consult your physician about health risks and your need for these shots.

If you are a railroader and covered by Medicare, it is important that billing go to Railroad Medicare and that your Railroad Medicare card is on file.

Providers new to Railroad Medicare and those who have supplied services to Railroad Medicare patients for years may have new staff that might file your claims to the wrong Medicare contractor in error. This can happen when they don’t notice that your Health Insurance Claim Number (HICN) is different from Social Security Administration (SSA) Medicare patients. 

Because Railroad Medicare HICNs vary from the SSA Medicare format, it’s important that your provider’s staff review your card to verify the number prior to billing Railroad Medicare.

Railroad Medicare beneficiaries have the same benefits as Social Security beneficiaries, but only one national carrier — Palmetto GBA Railroad Medicare, which processes all Railroad Medicare Part B claims.

If you are concerned that your provider is having problems submitting your claim correctly, call the Palmetto GBA Beneficiary Contact Center at (800) 833-4455, or (877) 566-3572 for those with hearing impairments.

If you have non-claim specific questions about your coverage with Railroad Medicare, you may visit the “My RR Medicare” page on Facebook at www.facebook.com/myrrmedicare.

 

Vaccine for the highly contagious H1N1 virus (commonly called “swine flu”) is now being released to the public as supplies become available. The information below will help you decide if you should obtain the vaccine.

The Centers for Disease Control and Prevention (CDC) currently recommends that certain priority groups should receive the H1N1 flu vaccine. These groups are:

  • pregnant women;
  • caregivers for children younger than six months of age;
  • health care and emergency medical services personnel;
  • children and young adults from six months through 24 years old;
  • persons aged 25 through 64 years who have underlying health conditions (such as asthma, diabetes, conditions that suppress the immune system, heart disease and kidney disease) that might increase their risk for flu-related complications.

In an effort to minimize the occurrence of H1N1 flu among railroad plan participants and their dependents, the Railroad Employees National Health and Welfare Plan and the National Railway Carriers and United Transportation Union Health and Welfare Plan and their medical vendors (Aetna, Highmark and UnitedHealthcare), as well as the Railroad Employees National Early Retirement Major Medical Benefit Plan and its medical vendor (UnitedHealthcare), have taken a number of steps to reduce the cost of immunization.

To that end, effective immediately, the plans named above will cover the administration of the H1N1 vaccine through the end of December 2009 for covered plan participants and dependents, with no co-pays, deductibles or coinsurance payments.

A decision as to whether or not this special coverage handling will be extended into 2010 will be made by the end of the year.

Where to get the vaccine

Employees and their dependents have a broad range of options from which to choose where to get the H1N1 flu vaccine:

  • Public health clinics: The H1N1 vaccine should be available at most local public health clinics at no cost. Please call the health clinic first to make sure it has the vaccine.
  • Retail pharmacies and other clinics: Please call the pharmacy or other clinic first to make sure it has the H1N1 vaccine available.
  • Doctor’s office: Contact your primary care physician or network provider to find out if the H1N1 vaccine is available and if you should be immunized. Please note office visit co-pays will not apply if you see your doctor solely to obtain the H1N1 flu vaccine.

For the latest information on the H1N1 flu vaccine, please visit the Centers for Disease Control website (www.cdc.gov/h1n1flu/) and/or contact your benefit administrator: