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Medicare Enrollment Rules Simplified - Effective January 2023

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There are three Medicare enrollment periods: Initial Enrollment Period (IEP), General Enrollment Period (GEP), and Special Enrollment Period (SEP).

Initial Enrollment Period (IEP)

When you turn 65 you will become eligible to enroll in Medicare through the Initial Enrollment Period (IEP). The IEP lasts for a total of 7 months, starting 3 months before you turn 65, and ending 3 months after the month you turn 65.

The exception to this rule applies if your birthday falls on the first day of the month. In that case, your 7-month enrollment will begin four months before the month you turn 65 and end two months after the month you turn 65.

Example:

If you turn 65 on May 11, 2026, your IEP will begin on February 1, 2026, and conclude on August 31, 2026.
If you turn 65 on May 1, 2026, your IEP will begin on January 1, 2026, and conclude on July 31, 2026.

Your Medicare Part B effective date depends on when you submitted your Medicare application.

If you enroll:	Coverage starts:	Example:
Before the month you turn 65	The month you turn 65	Mary turns 65 on June 4, 2026. She submitted her application on May 31, 2026. Her Medicare Part B will begin on June 1, 2026.
The month you turn 65	The next month	Sam turns 65 on September 4, 2026. He submitted his application on September 25, 2026. His Medicare Part B will begin on October 1, 2026
1 month after you turn 65	The next month	Joy turns 65 on February 5, 2026. She submitted her application on March 3, 2026. Her Medicare Part B will begin on April 1, 2026.
2 months after you turn 65	The next month	Tim turns 65 on May 5, 2026. He submitted his application on July 5, 2026. His Medicare Part B will begin on August 1, 2026.
3 months after you turn 65	The next month	Fiona turns 65 on January 3, 2026. She submitted her application on April 3, 2026. Her Medicare Part B will begin on May 1, 2026.

Note: If you are currently receiving a railroad and/or Social Security annuity paid by the Railroad Retirement Board, you do not need to apply for Medicare during your IEP. Your enrollment will be handled automatically.

You can also be eligible for Medicare prior to turning 65 if you qualify based on disability entitlement.

General Enrollment Period (GEP)

The General Enrollment Period is available for any eligible person who did not enroll during their IEP, SEP, or during another GEP. The GEP begins on January 1 and ends on March 31 each year.

If you sign up for Medicare Part B during the GEP, your coverage will become effective the month after your application date.

If you enroll:	Coverage starts:
In January	February 1
In February	March 1
In March	April 1

Note: If you enroll in the GEP because you missed your IEP or SEP, you may be required to pay a penalty rate in addition to the basic Medicare Part B penalty premium. The penalty rate increases for each 12-month period in which you were eligible for Medicare Part B but did not enroll. However, any month in which you had group health plan (GHP) or large group health plan (LGHP) coverage under current employment is excluded from the penalty calculation, provide that proof is submitted.

Special Enrollment Period (SEP)

The Special Enrollment Period (SEP) allows individuals who either missed or declined Medicare when they were first eligible because they had group health plan coverage based on current employment (your own, a spouse’s, or a family member’s if you are disabled).

The SEP allows you to delay enrolling in Medicare Part B without having to wait for a GEP and pay the penalty rate for late enrollment. The SEP allows you to:

enroll in Medicare Part B anytime while you are covered by group health plan based on current employment
enroll in Medicare Part B during the 8-month period that begins the month after your group health coverage ends or employment ends, whichever comes first.

If you enroll:	Part B coverage starts:
First Month	First day of that month or any of the next three months
Last Seven Months	First day of the month after the month of enrollment

Note: There is also a disability SEP, where you may apply within 7 months for an SEP based on one of the following notifications: the month the employer notifies you that Medicare is your primary payer or the month Medicare becomes your primary payer.

Special Enrollment Period – Exceptional Situations

The SEP is also for individuals who experienced a hardship that prevented them from enrolling in Medicare. Below are the following exceptional circumstances that may qualify for special enrollment:

Individuals Impacted by Emergency or Disaster – This option is available to you if you missed a Medicare enrollment due to being impacted by a disaster or other emergency declared by local, state, or Federal government entity.
Misrepresentation by Group Health Plan or Employer – This option is available to you if you missed a Medicare enrollment and can demonstrate that your employer or group health plan misrepresented information.
Termination of Medicaid Coverage – This option is available to you if you lost Medicaid eligibility and are eligible for Medicare.
Formerly Incarcerated Individuals – This option is available to you if you missed a Medicare enrollment due to being incarcerated and were released.
Other Exceptional Conditions – If none of the above situations fit your exceptional circumstances for missing your Medicare enrollment period, you can submit a SEP application for review under this provision.

The above exceptional conditions have different enrollment lengths and require specific criteria to be eligible for the enrollment type. If you are interested in learning more about a specific enrollment, contact your local field office.

Important Links: Medicare.gov
Medicare & You Handbook
Replacement Medicare Card
Medicare for Railroad Retirement Beneficiaries in Canada
Frequently Asked Questions (Medicare Related)

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Railroad Retirement Handbook

Read more about Railroad Retirement Handbook

CMS Offers Medicare Enrollment Relief for Americans Affected by Recent Disasters

Read more about CMS Offers Medicare Enrollment Relief for Americans Affected by Recent Disasters

The Centers for Medicare & Medicaid Services (CMS) is providing immediate relief to people who want to make a Medicare Part A or Part B enrollment request, but may have been impeded by the recent hurricanes and the wildfires in California.

The Centers for Medicare & Medicaid Services (CMS) issued a press release providing guidance and instruction on this initiative (10/30/17):

CMS Offers Medicare Enrollment Relief for Americans Affected by Recent Disasters

Los CMS ofrecen alivio en la inscripción a Medicare para los estadounidenses afectados por los desastres de clima recientes

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New Medicare Cards Are Coming

Read more about New Medicare Cards Are Coming

The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 mandates the removal of social security numbers from Medicare cards. As a result, every person with Medicare coverage will be receiving a replacement card displaying a new Medicare number that is unique to them. This change will better protect your identity. Railroad Retirement Board will mail you a new Medicare card by June of 2018.

The Centers for Medicare & Medicaid Services (CMS) issued a press release covering this initiative in greater detail (09/14/17):

Chose the following link to view a sample of the RRB Medicare Card.

In the meantime, beware of anyone who contacts you about your new Medicare card. Medicare or the RRB will never ask you for personal or private information in order for you to receive your new Medicare number and card.

Report all instances of fraud or potential fraud to 1-800-MEDICARE.

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Q&A: Disability Annuities for Railroad Employees

The Railroad Retirement Act provides disability annuities for railroaders who become totally or occupationally disabled. Medicare coverage before age 65 is also available for totally disabled employees and those suffering from ALS (Amyotrophic Lateral Sclerosis) or chronic kidney disease.

Read more about Q&A: Disability Annuities for Railroad Employees

Q&A: Acting for Impaired Railroad Retirement Annuitants

Railroad Retirement Board (RRB) policy states that every railroad retirement annuitant has the right to manage their own benefit payments. However, when an annuitant cannot do so because of physical or mental impairment, or if the RRB determines that the annuitant’s interests require it, the agency can appoint a person or an organization to receive railroad retirement benefit payments on the annuitant’s behalf as a representative payee.

Read more about Q&A: Acting for Impaired Railroad Retirement Annuitants

Q&A: Medicare for Railroad Families

The federal Medicare program provides hospital and medical insurance protection for railroad workers and their families, just as it does for workers under social security. Medicare has the following parts:

Read more about Q&A: Medicare for Railroad Families

Medicare Part B Premiums and Deductibles Will Increase in 2026

The Centers for Medicare & Medicaid Services (CMS) has set the standard monthly Part B premium at $202.90 in 2026, an increase of $17.90, or just under 10 percent, from the 2025 premium of $185.00. However, 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. The annual deductible for all Medicare Part B enrollees in 2026 will be $283, an increase of $26 from the 2025 deductible of $257.

Read more about Medicare Part B Premiums and Deductibles Will Increase in 2026

Palmetto GBA, RRB's Medicare

Read more about Palmetto GBA, RRB's Medicare

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 RRB.

Telephone Inquiries - If you would like to check the status of your Railroad Medicare Part B claim, you may call the Palmetto Interactive Voice Response (IVR) system toll-free at (800) 833-4455. From the main menu, press one ‘1’ for claim status. You will need your Railroad Medicare number, Date of Birth, Name, and Date of Service for the claim you are searching for. If you need help while using the IVR, Customer Service Representative Representatives (CSRs) are available by pressing zero ‘0’. Claim status and CSR are available Monday thru Friday from 7 a.m. – 11 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.

Spanish inquiries can be directed to (800) 833-4455.

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Medicare Premiums

Read more about Medicare Premiums

Learn about the basic costs for Medicare: Part A (hospital insurance). Part B (medical insurance) including Income Related Monthly Adjustment Amount (IRMAA) and late enrollment penalty. Medicare Advantage Plans (Part C) and what factors contribute to how much you pay out-of-pocket. The different types of Medicare drug coverage (Part D) and the costs you will pay in a Medicare drug plan. The current Medicare Part A, Part B, Part C, and Part D costs for monthly premiums, deductibles, penalties, copayments, and coinsurance.

Published by: Policy and Systems | Email: webmaster@rrb.gov