Disability throws a curve into Medicare eligibility status.
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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