Railroad Retirement Board benefits run parallel to Social Security and exist because the railroads' retirement system was already in place when Social Security became law in 1935. Medicare benefits are identical for RRB retirees and other Americans. Disability status may affect starting age for Medicare coverage, however. A number of regulations govern whether disabled railroad retirees can enroll in Medicare before age 65.
Automatic Medicare Eligibility
Healthy railroad retirees are automatically enrolled in Medicare at age 65 and pay Part B and Part A premiums, if any, to the RRB. Before age 65, they're covered by Medicare regardless of disability status if they have amyotrophic lateral sclerosis, called Lou Gehrig's disease. They're also Medicare-eligible after a three-month waiting period if they have permanent kidney failure. If they have kidney failure, they enroll in Medicare via the Social Security administration.
Early Eligibility for Medicare
The RRB recognizes two levels of disability based on length and severity. One is "total and permanent" disability. The other is occupational disability. With total and permanent disability -- usually just called total disability -- the employee is unable to work at all. Under total disability, railroad retirees can obtain Medicare coverage before age 65 if they have been disabled under RRB rules for at least two years and are also eligible for disability benefits under Social Security.
Temporary Disability and Medicare
Occupational disability is considered temporary. An occupationally disabled railroad employee cannot do his regular railroad job but may be able to work elsewhere. He must have an active connection with the industry and a 10-year working history in the industry to be declared occupationally disabled. Railroad employees' retirement benefits vary with the length of employment in any case, leading to one complication in Medicare eligibility: the "disability freeze." A disability freeze protects the employee from receiving lower retirement benefits as a result of the pause in active employment. The freeze ends after the employee makes a medical recovery.
Occupationally disabled employees who receive benefits but have not received a disability freeze are generally eligible for Medicare coverage at age 65. Those under a disability freeze are eligible starting with the 30th month after the date that the freeze begins. There are other wrinkles to disability status and Medicare eligibility. For example, according to the RRB disability handbook, the waiting period rule doesn't apply if the employee recovered from disability and then re-entered disability status, with a disability freeze, within five years of the month that the freeze began.
- SSA.gov: Office of Retirement and Disability Policy -- An Overview of the Railroad Retirement Program -- Social Security Bulletin; Vol.68, No. 2; Kevin Whitman
- RRB.gov: Railroad Retirement Board -- Medicare for Railroad Workers and Their Families
- MedicareInteractive.org: Is Medicare Different for Me if I Get It Through the Railroad Retirement Board?
- RRB.gov: Employment Disability Benefits
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