The Centers for Medicare & Medicaid Services has announced that the standard monthly Part B premium will be $135.50 in 2019, a slight increase from $134.00 in 2018. However, some Medicare beneficiaries will pay slightly less than this amount. 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.

Since that adjustment is 2.8 percent in 2019, about 2 million Medicare beneficiaries will see an increase in their Part B premiums but still pay less than $135.50. The standard premium amount will also apply to new enrollees in the program, and certain beneficiaries will continue to pay higher premiums based on their modified adjusted gross income.

The monthly premiums that include income-related adjustments for 2019 will range from $189.60 up to $460.50, depending on the extent to which an individual beneficiary’s modified adjusted gross income exceeds $85,000 (or $170,000 for a married couple). The highest rate applies to beneficiaries whose incomes exceed $500,000 (or $750,000 for a married couple). The Centers for Medicare & Medicaid Services estimates that about 5 percent of Medicare beneficiaries pay the larger income-adjusted premiums.

Beneficiaries in Medicare Part D prescription drug coverage plans pay premiums that vary from plan to plan. Part D beneficiaries whose modified adjusted gross income exceeds the same income thresholds that apply to Part B premiums also pay a monthly adjustment amount. In 2019, the adjustment amount ranges from $12.40 to $77.40.

The Railroad Retirement Board withholds Part B premiums from benefit payments it processes. The agency can also withhold Part C and D premiums from benefit payments if an individual submits a request to his or her Part C or D insurance plan.

The following tables show the income-related Part B premium adjustments for 2019. The Social Security Administration (SSA) is responsible for all income-related monthly adjustment amount determinations. To make the determinations, SSA uses the most recent tax return information available from the Internal Revenue Service. For 2019, that will usually be the beneficiary’s 2017 tax return information. If that information is not available, SSA will use information from the 2016 tax return.

Those railroad retirement and social security Medicare beneficiaries affected by the 2019 Part B and D income-related premiums will receive a notice from SSA by the end of the year. The notice will include an explanation of the circumstances where a beneficiary may request a new determination. Persons who have questions or would like to request a new determination should contact SSA after receiving their notice.

Additional information about Medicare coverage, including specific benefits and deductibles, can be found at


Beneficiaries who file an individual tax return with income:

Beneficiaries who file a joint tax return with income:

Income-related monthly adjustment amount

Total monthly Part B premium amount


Less than or equal to $85,000 

Less than or equal to $170,000



Greater than $85,000 and less than or equal to $107,000 

Greater than $170,000 and less than or equal to $214,000



Greater than $107,000 and less than or equal to $133,500 

Greater than $214,000 and less than or equal to $267,000



Greater than $133,500 and less than or equal to $160,000

Greater than $267,000 and less than or equal to $320,000



Greater than $160,000 and less than $500,000

Greater than $320,000 and less than $750,000



$500,000 and above

$750,000 and above




The monthly premium rates paid by beneficiaries who are married, but file a separate return from their spouses and who lived with their spouses at some time during the taxable year, are different.  Those rates are as follows:


Beneficiaries who are married, but file a separate tax return, with income:

Income-related monthly adjustment amount

Total monthly Part B premium amount

Less than or equal to $85,000



Greater than $85,000 and less than $415,000



$415,000 and above




The Centers for Medicare & Medicaid Services (CMS) is reviewing regulations that mandate how doctors and other practitioners document the services they provide. The focus is on the following:

  • Reducing unnecessary burden
  • Increasing process efficiencies
  • Improving the patient’s experience with their provider

CMS is beginning this process with evaluation and management services (office or outpatient visits). The goal is to increase the time providers spend with their patients and decrease the time spent documenting services. At the same time, CMS consistently seeks to reduce provider errors and unnecessary appeals.
CMS Administrator Seema Verma explained: “…we are moving the agency to focus on patients first. To do this, one of our top priorities is to ease the regulatory burden that is destroying the doctor-patient relationship. We want doctors to be able to deliver the best quality care to their patients.”
To see more information about the Patients Over Paperwork initiative, please visit the CMS website at
If you have questions about your Railroad Medicare coverage, you may call Palmetto GBA’s Beneficiary Contact Center at 800-833-4455, or for the hearing-impaired, call TTY/TDD at 877-566-3572. Customer service representatives are available Monday through Friday, from 8:30 a.m. until 7 p.m. ET. Visit Palmetto’s Facebook page at
Visit Palmetto GBA’s free online beneficiary portal at This tool offers you the ability to access Railroad Medicare Part B claims data, historical Part B Medicare Summary Notices (MSN), and a listing of individuals you have authorized to have access to your personal health information.

This is a final effort to collect dependent Social Security numbers to comply with new federal law for all medical plans including:

  • The Railroad Employees National Health and Welfare Plan; and
  • The National Railway Carriers and United Transportation Health and Welfare Plan

Federal Law now requires the reporting of Social Security numbers (SSNs) for covered dependents to the Centers for Medicare & Medicaid Services (CMS).

This includes participants of all medical plans, including the railroad plans listed above.

In addition, if a covered dependent is eligible for Medicare, then the Medicare Health Insurance Claim Number (HICN) is also required.

To comply with these reporting requirements, Railroad Enrollment Services has mailed a final notice to those members identified with missing dependent SSNs and/or HICNs.

If you have received a notice from Railroad Enrollment Services, please provide the SSN and/or HICN for any dependent who is listed as missing this information.

Be sure to sign, date and return the Social Security Number Reporting Form by the requested return date to the address provided.

If you do not receive a notice requesting missing dependent SSNs and/or HICNs, then you do not need to take any action at this time.

The following will occur if the requested SSNs are not provided for any dependent added to the plan before Jan. 1, 2009:

If Railroad Enrollment Services does not receive the Social Security number for any dependent whose SSN is missing by Jan. 31, 2011, the dependent(s) will be DISENROLLED from the plan effective Jan. 31, 2011.

Be assured that when Railroad Enrollment Services transmits the SSNs and/or HICNs to CMS, they will maintain all physical, electronic and procedural safeguards that comply with federal standards to guard your personal information.

For additional information regarding the new CMS federal law pertaining to this requirement, visit

If you have questions, or need another copy of the notification sent to you, call Railroad Enrollment Services at 800-753-2692.

Additionally, there will be an opportunity to provide missing dependent SSNs and/or HICNs during the 2011 Annual Open Enrollment process in the month of October.