Medicare Entitlement can be established under the Railroad Retirement Act as it is under the Social Security Act.

The RRB maintains a master eligibility file of all qualified RRB Annuitants which is equivalent to Social Security Administration's (SSA’s) Master Beneficiary Record (MBR) File. When RRB establishes Medicare for an annuitant, a record is generated to SSA for inclusion in the MBR file even though RRB maintains jurisdiction of the record. This situation also applies to those cases where dual entitlement (RRB Annuitant and SSA Title II Benefit) is involved - RRB maintains jurisdiction for Medicare eligibility.

When a Social Security Income (SSI) claim is being filed, the District Office (DO)/Branch Office (BO) should query the MBR file to determine whether Medicare entitlement exists or does not exist.

1. MBR - Medicare Entitlement Present - Proceed in developing the SSI claim for the beneficiary and follow instructions in item C below.

2. MBR - Medicare Entitlement Not Present or Record Not In File (NIF) - If it appears that the SSI applicant may also be eligible for Medicare the DO/BO should complete the exhibit in HI 00815.208 (Reproduce/copy the exhibit as needed) and proceed in developing the SSI claim, then follow the procedures in item C below.

Inform the beneficiary that, if they are eligible for Medicare, they may also be eligible for Medicare Part B under the State Buy-in Provision (see chart in HI 00815.009) and if so, their state of residence will pay the Medicare Part B monthly premium for them. Advise the beneficiary that it may take up to 3 or 4 months for all of the records to be established. The Buy-in determination will be made at that time. This activity does not have any effect on their SSI application.

Individual complaints from RRB annuitants concerning their buy-in status should be processed the same as any other buy-in complaint case (see HI 00815.070 through HI 00815.094 for problem case procedures). Do not send RRB Buy-in problem cases to the RRB.