#original medicare

[albaalexa]

Original Medicare (Part A and B) Eligibility And Enrollment

Original Medicare, consisting of Part A (Hospital Insurance) and Part B (Medical Insurance), is a federal health insurance program primarily for individuals aged 65 and older, as well as some younger individuals with qualifying disabilities. Understanding medicare eligibility requirements is crucial for accessing the benefits provided by Original Medicare.

Eligibility for Original Medicare:

Part A Eligibility:

Age: Individuals aged 65 and older are generally eligible for Part A.

Work History: Those under 65 may be eligible if they have received Social Security or Railroad Retirement Board disability benefits for 24 months.

End-Stage Renal Disease (ESRD): Individuals with ESRD requiring dialysis or a kidney transplant may qualify for Part A.

Part B Eligibility:

Age: Individuals aged 65 and older are eligible.

Work History: Under-65 individuals receiving Social Security or Railroad Retirement Board disability benefits for 24 months become eligible.

Citizenship or Legal Residency: Applicants must be U.S. citizens or legal residents who have lived in the U.S. for five consecutive years.

Enrollment Process:

Initial Enrollment Period (IEP):

Timing: Starts three months before the month of turning 65, includes the birth month, and continues for three months afterward.

Automatic Enrollment: Those receiving Social Security benefits are automatically enrolled in Parts A and B unless they opt-out.

Non-Automatic Enrollment: Individuals not receiving Social Security benefits must actively enroll.

General Enrollment Period (GEP):

Timing: Runs from January 1 to March 31 each year.

Eligibility: Individuals who missed their IEP can enroll but may face a late enrollment penalty.

Special Enrollment Periods (SEP):

Qualifying Events: Certain life events, like moving, losing employer coverage, or becoming eligible for other assistance programs, may trigger a SEP.

Timing: The timing and duration of SEPs vary depending on the qualifying event.

Enrollment Methods:

Online: Through the Social Security Administration (SSA) website or the Medicare website.

Phone: Contact the SSA or Medicare hotline.

In Person: Visiting a local SSA office or Medicare assistance site.

Coverage and Costs:

Part A Coverage:

Hospital Care: Inpatient hospital stays, skilled nursing facility care, hospice care, and some home health services.

Costs: Most beneficiaries don’t pay a premium for Part A, but there are deductibles and coinsurance.

Part B Coverage:

Medical Services: Doctor visits, outpatient care, preventive services, and some home health care.

Costs: Monthly premiums, annual deductibles, and coinsurance apply. Income-related monthly adjustment amounts (IRMAA) may increase premiums for higher-income individuals.

Original Medicare offers essential healthcare coverage for eligible individuals, providing access to necessary medical services and treatments. Understanding eligibility criteria, enrollment periods, and coverage options is crucial for ensuring timely access to healthcare benefits and managing associated costs effectively. Individuals approaching Medicare eligibility should familiarize themselves with these aspects to make informed decisions regarding their healthcare coverage.

[eloisemia]

Original Medicare (Part A and B) Eligibility and Enrollment

Original Medicare, consisting of Part A and Part B, is a fundamental healthcare program in the United States designed to provide essential medical coverage for eligible individuals. Understanding its eligibility criteria and enrollment process is crucial for those seeking to benefit from this program.

Eligibility for Original Medicare:

Part A Eligibility:

Part A primarily covers hospital care, skilled nursing facility care, nursing home care (in limited situations), hospice, and home health services.

To be eligible for Part A, individuals must meet one of the following conditions:

Age Requirement: Individuals aged 65 or older, who are citizens or permanent residents of the United States, are generally eligible for Part A.

Disability: Those under 65 with certain disabilities may also qualify for Part A if they've received Social Security Disability Insurance (SSDI) benefits for at least 24 months.

End-Stage Renal Disease (ESRD): Individuals with ESRD (permanent kidney failure requiring dialysis or a kidney transplant) can be eligible for Medicare regardless of age, provided they or their spouse has paid Medicare taxes for a certain period.

Part B Eligibility:

Part B covers medical services like doctor visits, outpatient care, preventive services, and some medical equipment and supplies.

Eligibility for Part B generally includes:

Age Requirement: Individuals aged 65 or older.

Enrollment in Part A: To be eligible for Part B, one must already be enrolled in Part A.

U.S. Citizenship or Legal Residency: Like Part A, Part B eligibility requires U.S. citizenship or legal residency.

Enrollment in Original Medicare:

Initial Enrollment Period (IEP):

For most individuals, the Initial Enrollment Period begins three months before the month of their 65th birthday and ends three months after their birthday month. It's advisable to enroll during this period to avoid potential late enrollment penalties.

Special Enrollment Period (SEP):

Some individuals may qualify for a Special Enrollment Period, allowing them to enroll in Medicare outside the Initial Enrollment Period without facing penalties. Qualifying events for SEP include continued employment with employer-based coverage past age 65 or coverage under a spouse's employer-based plan.

General Enrollment Period (GEP):

If someone misses their Initial Enrollment Period and doesn't qualify for a Special Enrollment Period, they can enroll during the General Enrollment Period, which runs from January 1 to March 31 each year. However, late enrollment penalties may apply.

Automatic Enrollment:

Individuals receiving Social Security benefits are typically automatically enrolled in both Part A and Part B when they become eligible. They receive their Medicare card in the mail approximately three months before their 65th birthday or 25th month of disability benefits.

Enrollment Process:

Enrollment in Original Medicare can be done online through the Social Security Administration (SSA) website, by visiting a local SSA office, or by contacting SSA via phone. The process involves completing an application form and providing the necessary documentation to verify eligibility.

Conclusion:

Original Medicare, comprising Part A and Part B, serves as a vital healthcare safety net for millions of Americans. Understanding the Medicare eligibility requirements is essential for individuals approaching Medicare age, as timely enrollment ensures access to essential healthcare services without incurring penalties. It's advisable to research and plan accordingly to make informed decisions regarding Medicare enrollment and coverage options. Additionally, individuals may consider supplementary coverage options like Medicare Advantage (Part C) or Medicare Prescription Drug Plans (Part D) to enhance their healthcare coverage according to their specific needs.

[aislingbast]

Original Medicare (Part A and B) Eligibility And Enrollment

Original Medicare, comprising Part A (Hospital Insurance) and Part B (Medical Insurance), is a fundamental component of the U.S. healthcare system. Understanding eligibility criteria and the enrollment process is crucial for individuals seeking comprehensive coverage as they age.

Let’s take a look at different medicare eligibility requirements:-

Age and Citizenship Requirements

Original Medicare eligibility primarily hinges on age. Individuals become eligible when they turn 65, provided they are U.S. citizens or permanent legal residents who have lived in the country for at least five continuous years. However, certain individuals may qualify for Medicare before turning 65 if they have a qualifying disability or medical condition.

Automatic Enrollment for Most

Many individuals are automatically enrolled in Medicare when they turn 65. This automatic enrollment typically occurs if they are already receiving Social Security or Railroad Retirement Board (RRB) benefits. The enrollment process is initiated about three months before an individual turns 65 and is completed by the first day of the month they turn 65.

Enrollment for Those Not Receiving Social Security Benefits

If an individual is not receiving Social Security benefits, they need to actively enroll in Medicare. This can be done online through the Social Security Administration's website or by visiting a local Social Security office. The Initial Enrollment Period (IEP) begins three months before the individual turns 65 and extends for seven months (three months before, the month of, and three months after).

Part A Premiums and Work History

While most individuals do not pay a premium for Medicare Part A, some may need to pay a premium if they have not worked long enough to qualify for premium-free Part A. Individuals qualify for premium-free Part A based on their own or their spouse's work history, having paid Social Security taxes for at least 40 quarters (10 years). Those who do not meet this requirement may still be eligible but may need to pay a premium.

Part B Premiums and Late Enrollment Penalties

Medicare Part B typically comes with a monthly premium, and late enrollment may result in penalties. The standard Part B premium amount is set annually and can vary based on income. Individuals need to enroll during their Initial Enrollment Period to avoid these penalties. If someone delays Part B enrollment and does not have creditable health coverage, they may face a permanent late enrollment penalty.

Special Enrollment Periods (SEPs)

Certain individuals may qualify for Special Enrollment Periods outside the Initial Enrollment Period. SEPs allow individuals to enroll in Medicare outside the standard enrollment periods without facing penalties. Qualifying events for SEPs include delaying Medicare enrollment due to employer coverage, coverage through a spouse's employer, or other specific circumstances.

Coordination with Other Health Coverage

For individuals who continue working past the age of 65 and have employer-sponsored health coverage, understanding the coordination between employer coverage and Medicare is crucial. In some cases, individuals may delay enrolling in Medicare Part B without facing penalties if they have qualifying employer coverage.

Choosing Additional Coverage (Medigap and Part D)

While Original Medicare provides essential coverage, many individuals opt for additional coverage through Medigap (Medicare Supplement Insurance) and Medicare Part D (prescription drug coverage). Medigap policies help cover costs such as deductibles and coinsurance, while Part D provides prescription drug coverage. These additional coverages are purchased separately, and enrollment periods may apply.

Conclusion

Original Medicare, comprising Parts A and B, serves as a foundation for healthcare coverage for eligible individuals in the United States. Understanding the eligibility criteria, enrollment periods, and potential additional coverages is vital for making informed decisions about healthcare. Whether enrolling automatically or actively, individuals approaching the age of eligibility should explore their options, consider their healthcare needs, and make decisions that align with their overall well-being. Staying informed about any updates or changes to Medicare policies ensures individuals can navigate the healthcare landscape effectively.

[rodgermalcolmmitchell]

Medicare Advantage, the prior authorization scam

Preface Medicare Advantage exists only because the federal government tells you the Big Lie in economics that federal taxes fund federal spending. They don’t. Federal taxes fund nothing. Federal taxes are destroyed upon receipt by the Treasury. Federal spending is funded by new dollar creation. The purposes of federal taxes are not to fund federal spending but to: Control the economy by taxing…

[avaa7944]

Switching from Original Medicare to Medicare Advantage

Medicare, the federal health insurance program for individuals aged 65 and older, as well as some younger individuals with disabilities, offers two primary options: Original Medicare (Part A and Part B) and Medicare Advantage (Part C).

While Original Medicare provides coverage for hospital and medical services through government-run programs, Medicare Advantage plans are offered by private insurance companies approved by Medicare. If you’re considering switching from Original Medicare to Medicare Advantage Plans, here’s a comprehensive guide to help you make an informed decision.

Understanding the Basics: Original Medicare vs. Medicare Advantage

Before making any decisions, it’s crucial to understand the fundamental differences between Original Medicare and Medicare Advantage:

Original Medicare (Part A and Part B):

Part A: Covers hospital care, skilled nursing facility care, hospice care, and some home health care.

Part B: Covers medical services and supplies such as doctor visits, outpatient care, preventive services, and durable medical equipment.

Original Medicare generally allows you to see any healthcare provider or specialist who accepts Medicare, giving you flexibility in choosing your healthcare providers.

Medicare Advantage (Part C):

Combines Parts A and B: Medicare Advantage plans to cover the same services as Original Medicare but are provided by private insurance companies.

May Include Extra Benefits: Many Medicare Advantage plans offer additional benefits like prescription drug coverage (Part D), dental, vision, hearing, and wellness programs.

Network Restrictions: You typically need to use healthcare providers within the plan’s network, which may limit your choices compared to Original Medicare.

Premiums and Cost-sharing: While you’ll still pay the Medicare Part B premium, Medicare Advantage plans often have their premiums, copayments, and deductibles.

Steps to Switching from Original Medicare to Medicare Advantage:

Research Medicare Advantage Plans: Start by researching the available Medicare Advantage plans in your area. You can use the official Medicare Plan Finder tool or consult with an insurance broker. Consider factors such as premiums, deductibles, copayments, and the network of doctors and hospitals.

Compare Benefits: Pay close attention to the extra benefits offered by Medicare Advantage plans. These can include prescription drug coverage, dental, vision, hearing, and wellness programs. Assess whether these additional benefits align with your healthcare needs.

Enrollment Periods: You can generally switch to a Medicare Advantage plan during specific enrollment periods:

Initial Enrollment Period (IEP): When you first become eligible for Medicare.

Annual Enrollment Period (AEP): Occurs annually from October 15 to December 7. During this period, you can switch from Original Medicare to Medicare Advantage or between different Medicare Advantage plans.

Special Enrollment Period (SEP): Certain life events, like moving to a new area or losing other coverage, may trigger a Special Enrollment Period.

Enroll in a Medicare Advantage Plan: Once you’ve selected a Medicare Advantage plan that suits your needs, you can enroll during the appropriate enrollment period. You can usually do this online, by phone, or by completing a paper application provided by the plan.

Disenrollment from Original Medicare: When you enroll in a Medicare Advantage plan, you will be automatically disenrolled from Original Medicare. Keep in mind that you should no longer use your Original Medicare card; instead, you’ll use the Medicare Advantage plan’s card.

Switching from Original Medicare to Medicare Advantage is a significant decision that should be based on your individual healthcare needs and preferences. Be sure to carefully research your options, understand the associated costs, and consult with a Medicare expert or insurance broker if needed to make an informed choice that best suits your situation.

[claeysgroup]

Medicare Open Enrollment Guide

Medicare Open Enrollment period kicks off October 15 and continues through December 7. During this time-frame, most Medicare beneficiaries can make necessary changes to their health and drug coverage options. If you missed your Initial Enrollment Period in October or qualify for a Special Enrollment Period, now is your only chance to enroll for Parts A and B this year. Medicare Open Enrollment…

[girlfriendsofthegalaxy]

helping

[reasonandempathy]

How does universal healthcare contribute to lower car insurance? Your post doesn't explain that, and I'm interested.

In the US if you are hit by a car and sue the insurance company you can get them to pay for your medical bills as collateral damage from the accident, even if you have (or don't have) medical insurance yourself.

As such, in Germany (for example) where medical costs are drastically lower, since the potential exposure is much smaller than the premiums don't need to be anywhere near as expensive.

as an example: if you get hit by a car and break your leg in the US it can cost $17k to $35k. In Germany the average cost is $5,349, with a maximum price of $10,000. Considering it could cost 3.5x more to repair a broken leg in the US than the maximum amount possible in Germany (we are also ignoring additional costs from surgical complications in this instance, but rest assured that only makes the potential risk higher) it makes sense that they would need two, three, or four times as much in premiums to cover those costs.

[slashingdisneypasta]

Ughhhhhh my sister's worrying cuz she cant find her birth certificate and my mum is just telling her, with the most blue-eyed, serious, focused stare 'Well i cant prove you exist now, you have no proof, you cant get a license or anything'- no comfort, no 'we'll figure it out', no 'we'll research how to get a new one- I'm sure we can'.

This is why I don't tell her anything when I'm stressed. She sucks in a crisis.

[misterlemonztenth]

07-23-23 | IT'S STILL TIME FOR MEDICARE FOR ALL, folks. Now more than ever. We've just received a major spanking from the Universe for not having made it a reality already. If you want Joe and Kamala to run for reelection with #MedicareforAll, tell them on the White House contact page: <https://www.whitehouse.gov/contact/>. https://misterlemonztenth.tumblr.com/archive

[andrhomeda]

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[ricinus-headache]

танька мотає астму від поранень

дуже тепла замальовка але більше не існує через їбучу туш яка перелилася з попередньої сторінки

[batboyblog]

Things Biden and the Democrats did, this week #11

March 22-29 2024

The Administration, with Transportation Secretary Pete Buttigieg in the lead responded to the collapse of the Francis Scott Key Bridge in Baltimore. Working with Governor Wes Moore and Mayor Brandon Scott (both Democrats) The Department of Transportation promises to clear the harbor and rebuild the bride. DoT has already released $60 million in emergency funds as a "down payment" and President Biden is expected to seek $1 billion from Congress.

Vice President Harris announced a number of actions and investments designed to improve the quality of life of the peoples of northern central America. driven by poverty, lack of economic opportunities, and out of control crime people in Guatemala, El Salvador, and Honduras are taking great risks and trusting criminal human traffickers to try to reach the US. The Administration is working to improve conditions in the Northern Triangle so that is no longer necessary. Vice President Harris announced $1 billion dollars in new investments as part of the Central America Forward public-private partnership, since 2021 it has invested $5.2 billion in the region. Harris also announced $175 million dollars of direct aid from the US to Guatemala at a meeting with Guatemalan President Bernardo Arévalo.

The Department of Energy announced a $1.5 billion dollar loan to help restart the Palisades Nuclear Plant. This would mark the first time a nuclear power plant was brought back online after being decommissioned. The hope is keep the plant running till 2051, this 100% green power source is projected to prevent 111 million tons of CO2 emissions in its new life time, the same as taking 100,000 cars off the road. Michigan Governor Gretchen Whitmer touted it as key for her state reaching its goal of 100% clean energy by 2040.

Vice President Harris launched a social media push to inform the public about the Biden-Harris Administration's SAVE Plan. The Saving on a Valuable Education (SAVE) Plan was launched last year as part of President Biden's efforts to bring student loan forgiveness to millions of borrowers. Currently 7.7 million people are enrolled in SAVE, under which anyone making $16 a hour or less has a monthly payment of $0 on their student loans. 4.5 million SAVE enrollees are making $0 a month payments and another 1 million pay less than $100 a month on their loan repayment, over 150,000 people so far have had their loans totally forgiven. Republicans are suing to try to shut down the SAVE Plan

President Biden took keep steps to ensure quality healthcare this week. Biden extended the window for low-income Americans to apply for Obamacare. The original deadline of July 31st has been pushed back to November 30th. Biden also rolled back Trump era rules that allowed subsidies for "Junk Health insurance" These plans offer very little coverage and often mislead consumers into believing they have insurance when they aren't covered. These short term plans also don't have meet Obamacare standards and can refuse coverage for preexisting conditions.

The EPA announced new regulations aimed at "turbocharging" the number of electric trucks on the road. The new rules aim to have 25% of new long-haul trucks, the heaviest often diesel trucks on the road, and 40% of medium-size trucks (box trucks and landscaping vehicles) be nonpolluting by 2032, currently just 2% are. The regulation would apply to more than 100 types of vehicles including tractor-trailers, ambulances, R.V.s, garbage trucks and moving vans. The new tailpipe limits are expected to prevent about a billion tons of greenhouse gas emissions by 2055.

the Centers for Medicare & Medicaid Services  announced that thanks to President Biden's Inflation Reduction Act, 41 different drugs will coast those on Medicare Part B less money than it did last year.  An estimated 763,700 people on Medicare use at least one of these drugs every year. Some enrollees will save as much as $3,575 per dose.

The Department of Energy announced $6 billion for an effort to decarbonize energy-intensive industries. The investment in 33 projects across 20 states will eliminate 14 million metric tons of CO2 emissions each year when finished. Each project is meant to be highly replicable and serve as a blueprint for future private sector ventures. 

President Biden signed an Executive Order to Strengthen the Recognition of Women’s History. The Order will launch a review of all historic sites run by the National Parks Service to determine ways to better highlight the role of women, from all backgrounds, in American History.

The Senate Confirmed President Biden's nominees, Ernesto Gonzalez, and Leon Schydlower to federal judgeships in Texas. This brings the total number of federal judges appointed by President Biden to 190.

[chrliekclly]

if you ever want to talk about your thoughts on joyce .. Peeks over the corner of your blog. i love talking and hearing ppls thoughts on joyce sooo much even if they're different from my own!! and your analysis and stuff is always so well thought out

i hope u dont mind if i answer this publicly to take advantage of th request nd get my ideas out ther (also tyvm im happy u like my insane takes on these idiots, iv ben thinking abt them for almost 10 years)

i said a lot here so gnna 'read more' it

iv ben building trans charlie n my head fr, like i said, nearly 10 years. i used to view him as cis bcuz i always try to take as much frm th source material as i can wen i craft my HCs nd i had v personal (stupid) hangups insofar as him explicitly referring to his junk multiple times nd bottom surgery simply not being on my radar as a naive littl trans idiot deep in th sauce tht transmen oftn fall into w phallo being viewed so so poorly

evn still i leaned towards transmasc charlie nd always lovd moments tht let me imagine, for a moment, it being true, like his discomfort w taking off his shirt [hundred dollar baby, charlie kelly: king of the rats, the gang exploits the mortgage crisis, young charlie and mac deleted scenes, etc etc etc], or bonnie yelling abt ppl stealing her "charlie-girl" [the waitress is getting married] which i lovd to see as her accidentally misgendering him while drunk off her ass.

having grown out of my phallo issues (nd if ur reading this and u still view phallo super poorly, please do some research and grow too), ive in recent years fully subscribed to transmasc/nb charlie, and view his timeline something like this:

baby -> elementary: charlie refers to himself as a boy, doesnt "come out," simply has no idea he's afab. bonnie lets him dress however he wants and refers to him as asked. when charlie gets confused about his genitals, bonnie says his dick will grow in later lol, makes charlie wear a dress in public restrooms and tells him its just a game

middle: puberty hits and charlie gets confused and scared. bonnie puts him on blockers w.o explaining them ("my mom used to vaccinate me like every month" [the gang gets quarantined]) charlie goes on content and oblivious. STP acquired because hes "a late bloomer" and his dicks still not growing in?? weird. confides this in mac once, but he doesn't understand.

high: charlie finally registers that he's trans after forgetting theres a health class 1 day and not being able to skip it. throws him for a loop a bit but he becomes actively invested in his goals. he gets to start T and wants to have surgeries. "what guy hasnt done some extensive research on his own genitalia?" [mac is a serial killer]

college (aged): able to surgically transition (ty medicare) and continues on with life as we kno him now

joyce, imo, fits neatly into these views.

as a transmasc nb who came out young nd prefers to be seen as just A Guy by strangers, i grew up v vehemently against anything girly that might get me misgendered, but th more i began to 'pass,' th more @ home n my body i felt, th more and more comfortable i am w femininity, th more i wdnt mind putting on a dress, as long as th general public wd see me as "a man in women's clothes." n my mind, i prescribe something not exactly th same but v similar to charlie.

i see charlie "i dont really identify" kelly as afab and nb. i see joyce as a "character" he originally created to distance himself from the dysphoria of putting on a dress as a young trans boy, but that became part of him as the hard lines he drew in the sand as a child became blurry with age and self acceptance. charlie's comfort with himself allows joyce to evolve into a more solid persona, one he enjoys embodying and allowing to become a permanent facet of who he is. he's ok with being referred to as either. they're both him.

so maybe joyce comes out a bit more outside of the bathroom now.

[scientia-rex]

I think often of the person who works with a major lab group who was surprised to the point of disbelief that I can’t reliably get labs drawn (bc lab will refuse to draw if they don’t think it will be covered) or covered (bc even if they get drawn, they’re often not covered). Our local lab group IS part of one of the major US groups. Today I tried to get an HIV screening lab for a patient who is on PreP. They’re being entirely conscientious and appropriate about their screening, and lab declined to draw as “you can’t have more than one in a year,” which seems sus, so I sifted through the Medicare coverage guide (nightmare manual, almost unreadable) and found a code that was listed as covered for that test and when I went to put it in, Epic gave me a warning that that code would not be covered. Unless I switched back to the original code. That the lab didn’t want to draw with.

I’m losing my fucking mind.

Relatedly, someone (in lab?) canceled two orders I had put in under “insomnia” and reordered them under childhood disorder Z codes so none of it got covered including the OTHER two orders they DIDN’T fuck with, and the clinic manager gave me shit about it. NOT! MY! IDEA!