November 26, 2015

Medicare Part B premiums for 2016


The Centers for Medicare & Medicaid Services has announced that the standard monthly Part B premium will be $121.80 in 2016. However, most Medicare beneficiaries will not see an increase in their monthly Part B premiums because of a “hold harmless” provision in the law. Under that provision, Part B premiums cannot increase for current [...]

Palmetto GBA: when a doctor’s notes are not readable


We all know the joke: if you have poor penmanship, you should become a doctor.  Unfortunately, poor penmanship on patient notes and records can lead to claim denials, because if Medicare can’t read what the doctor wrote, we can’t know if the services were reasonable and necessary and meet all guidelines for coverage. Medicare requires [...]

Medicare’s program integrity initiatives


For many years, the Centers for Medicare & Medicaid (CMS) has funded programs to reduce claims payment errors (either paying too much, paying too little or payments being made when none should be).  Some of these programs are handled through systematic checks that look for anomalies and mismatched services, and some are handled through clinical [...]

A new year can mean a new you with Medicare

The start of a new year is the time for resolutions. Railroad retirees covered under Medicare can receive the help they need in making some of their resolutions a reality. According to, the top three New Year’s resolutions are: Lose Weight Volunteer Quit Smoking The year 2015 can be a year of change with [...]

Palmetto GBA conducting Railroad Medicare survey


Palmetto GBA is conducting a Railroad Medicare Beneficiary Satisfaction Survey. The survey is designed to collect data on beneficiary satisfaction regarding its performance as Railroad Medicare’s contractor. The survey will be sent to a random sample of approximately 8,000 Railroad Medicare Beneficiaries. The surveys will be included in an upcoming Medicare Summary Notice (MSN). Palmetto GBA is listening and wants [...]

Medicare: Consider insurance when traveling abroad


When planning a foreign trip, it’s highly unlikely your first thought would be, “Will Medicare pay if I get injured or have a medical emergency before I get back home?” Many patients think their Medicare benefits will provide coverage, wherever they go. Unfortunately, this isn’t true and can lead to costly, and avoidable, mistakes. Generally, [...]

Need a doctor? Here’s how to find one


If you find yourself in need of a doctor, and you don’t know if one practices near you, or if they participate in Medicare, and you have internet access, you can use the ‘Physician Compare’ tool at Physician Compare is a website maintained by the Centers for Medicare and Medicaid Services (CMS), and it [...]

RRB discusses Medicare for railroad families


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 has the following parts: 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, [...]

When Railroad Medicare pays first or second

Palmetto GBA logo

When Medicare began in the 1960s, it was the primary payer for all services except those covered by workers compensation. In 1980, Congress enacted provisions to shift costs from the Medicare program to private insurers, when possible. This legislation stopped Medicare from making payment if the payment had already been made, or would be expected [...]

Flu season is here, shots covered by RR Medicare

It’s that time again. Flu season is upon us and the flu shot is available to be taken now. There are between 135 and 139 million vaccinations available this year. Medicare Part B (including Railroad Medicare) normally pays for one flu shot per flu season. There are two ways to take the vaccine – by [...]