Medicare Advantage Plans (HMOs)

Yes, Railroad Medicare beneficiaries can choose to enroll in Medicare Advantage plans.

Last Reviewed: 12/16/2024

Since Railroad Medicare beneficiaries will have Railroad Medicare cards even when enrolled in a Medicare Advantage plan, we suggest the following:

• Ask your patients to present all of their insurance cards on each visit
• Ask your patients if they have recently enrolled in any new health insurance plans
• Prior to submitting Medicare Part B claims to Railroad Medicare, verify patient eligibility through the Palmetto GBA eServices internet portal tool or our Interactive Voice Response unit (IVR) 

Last Reviewed: 12/16/2024

Yes. The Eligibility, Plan Coverage tab provides information regarding the beneficiary's enrollment under Medicare Advantage (MA) plans, Part D plans and/or MA Managed Care Plans (Part C contracts) that provide Part A and B benefits for beneficiaries enrolled under a contract. For more information, see the eServices User Manual (PDF). 

eServices returns the eligibility information that is currently available to Railroad Medicare. Because there may be a time lag between the effective date of a patient’s Medicare Advantage plan enrollment/disenrollment and Medicare records being updated, it is important to also ask the patient about all health insurance plans they may have.

Last Reviewed: 12/16/2024

Yes. Currently, the IVR will give information about Medicare Advantage plan and other Medicare Health plan enrollment. For information on using the IVR to check eligibility, see the Railroad Medicare Interactive Voice Response (IVR) User Guide.

The IVR returns the eligibility information that is currently available to Railroad Medicare. Because there may be a time lag between the effective date of a patient’s Medicare Advantage plan enrollment/disenrollment and Medicare records being updated, it is important to also ask the patient about all health insurance plans they may have.

Note: Effective January 31, 2025, at 7 p.m. ET, beneficiary eligibility will no longer be available on the Palmetto GBA IVR. See our Coming Soon: Beneficiary Eligibility Information Will Be Unavailable in the Interactive Voice Response System article for details.

Last Reviewed: 12/16/2024