OMB control number
Medicare
OMB 3220-0082 · RRB.
The Railroad Retirement Board administers the Medicare program for persons covered by the railroad retirement system. The forms in the collection obtain both information needed to enroll non-retired employees and survivor applicants in the plan and information from railroad employers needed to determine if a railroad retirement beneficiary is entitled to a special enrollment period when applying for supplemental medical coverage under Medicare.
The latest form for Medicare expires 2028-05-31 and can be found here.
Document Name |
|---|
Form and Instruction |
Form and Instruction |
Supporting Statement A |
Justification for No Material/Nonsubstantive Change |
Supplementary Document |
Supplementary Document |
Supplementary Document |
Supplementary Document |
Supplementary Document |
Form AA-6 (XX-XX) Propo Medicare
Form RL-311F (08-22) Cu Employer Coverage Under an Employer Group Health Plan
Medicare Medicare
Federal Enterprise Architecture: Income Security - General Retirement and Disability
| Form AA-6 (01-18) Current | Employee Application for Medicare | Paper Only | Form and instruction |
| Form AA-8 (01-18) Current | Widow Widower Application for Medicare - Medical Insurance (Part B) Program | Paper Only | Form and instruction |
| Form AA-7 (01-18) Current | Spouse Divorced Spouse Application for Medicare | Paper Only | Form and instruction |
| Form AA-23 (XX-XX) Proposed | Application for Medicare - Medical Insurance (Part B) | Paper Only | Form and instruction |
| Form AA-24 (XX-XX) Proposed | Application for Medicare Part B - Exceptional Conditions | Paper Only | Form and instruction |
| Form AA-8 (XX-XX) Proposed | Widow Widower Application for Medicare - Medical Insurance (Part B) Program | Paper Only | Form and instruction |
| Form AA-6 (XX-XX) Proposed | Employee Application for Medicare | Paper Only | Form and instruction |
| Form AA-7 (XX-XX) Proposed | Spouse Divorced Spouse Application for Medicare | Paper Only | Form and instruction |
Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.