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115-718: SmarTrip is a contactless stored-value smart card payment system managed by the Washington Metropolitan Area Transit Authority (WMATA). The Maryland Transit Administration (MTA) uses a compatible payment system called CharmCard . A reciprocity agreement between the MTA and WMATA allows either card to be used for travel on any of the participating transit systems in the Baltimore-Washington metropolitan area . Unlike traditional paper farecards or bus passes, SmarTrip/CharmCard

230-501: A "deductible") at the beginning of the 60 days of $ 1632 as of 2024. Days 61–90 require a co-payment of $ 408 per day as of 2024. The beneficiary is also allocated "lifetime reserve days" that can be used after 90 days. These lifetime reserve days require a copayment of $ 816 per day as of 2024, and the beneficiary can use a total of only 60 of these days throughout their lifetime. A new pool of 90 hospital days, with new copays of $ 1632 in 2024 and $ 408 per day for days 61–90, starts only after

345-456: A $ 3 credit was refunded to the card five days after first use. Also starting September 1, riders have been required to have a minimum balance of $ 1.20 on their SmarTrip cards (35¢ for half-fare senior/disabled cards) in order to enter the Metrorail system, which reduced the possible negative balance upon exit. Effective October 1, 2013, the price of the card was reduced to $ 2, the rebate program

460-577: A SmarTrip card at Metrorail stations or by using cash while boarding a Metrobus. In November 2008, after years of delays, WMATA announced that customers would have the ability to add funds to their SmarTrip cards online by September 2009, but that deadline was missed. WMATA did launch SmarTrip's online reload feature in September 2011. WMATA allowed customers to load a seven-day unlimited Metrorail pass to their SmarTrip cards in April 2012. All trips made with

575-417: A SmarTrip card, with the exception of bus transfers and passes, are charged as individual one-way fares. WMATA offers discounted rail and bus passes to customers who make several trips in one day, or many trips, or many short trips, in a seven-day period or calendar month; however, SmarTrip users must manually load each transit pass onto their SmarTrip cards or sign up for an autoload of the pass in advance. This

690-571: A beneficiary's covered medical costs and many costs and services are not covered at all. The program contains premiums , deductibles and coinsurance, which the covered individual must pay out-of-pocket . A study published by the Kaiser Family Foundation in 2008 found the Fee-for-Service Medicare benefit package was less generous than either the typical large employer preferred provider organization plan or

805-526: A bill providing for healthcare for the elderly, all without success. In 1963, however, a bill providing for both Medicare and an increase in Social Security benefits passed the Senate by 68-20 votes. As noted by one study, this was the first time that either chamber “had passed a bill embodying the principle of federal financial responsibility for health coverage, however limited it may have been.” There

920-424: A closed system that emulates the physical smart card and works with current fare collection equipment. The reduced scope of the project lowered costs dramatically, while constraining users to loading a balance on a SmarTrip account instead of paying directly from a credit/debit card. Mobile payments through Apple Pay were added in 2020, with Google Pay support following in 2021. Since March 6, 2016, SmarTrip cards are

1035-745: A compatible payment system from the same manufacturer. A reciprocity agreement allows patrons to use either payment card to travel on any of the participating systems throughout the Baltimore-Washington Metropolitan Area . However, digital SmarTrip cards stored in Apple Wallet will not work on any Baltimore MTA vehicle. The following systems serve the Baltimore–Washington Area, but do not currently accept SmarTrip or CharmCard as payment *Select routes do accept SmarTrip. **SmarTrip can be used to purchase

1150-896: A component of the U.S. Department of Health and Human Services (HHS), administers Medicare, Medicaid , the Children's Health Insurance Program (CHIP), the Clinical Laboratory Improvement Amendments (CLIA), and parts of the Affordable Care Act (ACA) ("Obamacare"). Along with the Departments of Labor and Treasury , the CMS also implements the insurance reform provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and most aspects of

1265-1088: A copay for outpatient drugs and respite care, if needed. The Monthly Premium for Part B for 2024 is $ 174.70 per month. Part B coverage begins once a patient meets his or her deductible ($ 240 for 2024), then typically Medicare covers 80% of the RUC-set rate for approved services, while the remaining 20% is the responsibility of the patient, either directly or indirectly by private group retiree or Medigap insurance. Part B coverage covers 100% for preventive services such as yearly mammogram screenings, osteoporosis screening, and many other preventive screenings. Part B also helps with durable medical equipment (DME), including but not limited to canes , walkers , lift chairs , wheelchairs , and mobility scooters for those with mobility impairments . Prosthetic devices such as artificial limbs and breast prosthesis following mastectomy , as well as one pair of eyeglasses following cataract surgery , and oxygen for home use are also covered. Anyone on Social Security (SS) in 2019

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1380-472: A country in non-cash forms such as on stored-value cards. There is concern that stored-value cards can be used for money laundering , that is, moving offshore funds derived from criminal activities such as drug trafficking . There are reports of these cards being used by Mexican drug cartels to transfer money across borders. For example, in the United States , it is legal for anyone to enter or leave

1495-517: A crime for an issuer to conduct a money transmitting business without a license. Cardholders generally suffer from the same problems that closed system card holders suffer. It is unclear whether or not Chapters 7 and 11 of the Bankruptcy code are applicable to these types of cards. It is common for countries to place limits on how much currency may be taken out of or brought into a country. However, these limits generally do not apply to money leaving

1610-448: A final rule concerning eligibility for hospital inpatient services effective October 1, 2013. Under the new rule, if a physician admits a Medicare beneficiary as an inpatient with an expectation that the patient will require hospital care that "crosses two midnights", Medicare Part A payment is "generally appropriate". However, if it is anticipated that the patient will require hospital care for less than two midnights, Medicare Part A payment

1725-465: A license. Closed system prepaid cards are not subject to the USA PATRIOT Act , as they generally cannot identify a customer. As debts owed to consumers who purchased the card, these purchases remain on the books of a merchant as a liability rather than an asset. Consequently, gift certificates and merchant gift cards have fallen under state escheat or abandoned property laws (APL). However,

1840-465: A long term disability that would prevent you from working, End-Stage Renal Disease, or Amyotrophic lateral sclerosis then you may be eligible for Medicare at an earlier age. Individuals receiving Social Security Disability Insurance (SSDI) benefits for 24 months are automatically enrolled in Medicare Parts A and B in the 25th month. Individuals with permanent kidney failure requiring dialysis or

1955-403: A merchant and may only be redeemed for purchases from the merchant. They are typically of fixed amounts and are commonly known as merchant gift cards or store cards. These cards are typically purchased to be used as gifts, and are increasingly replacing the traditional paper gift certificate. Generally, few if any laws govern these types of cards. Card issuers or sellers are not required to obtain

2070-539: A month. A new income-based premium surtax schema has been in effect since 2007, wherein Part B premiums are higher for beneficiaries with incomes exceeding $ 85,000 for individuals or $ 170,000 for married couples. Depending on the extent to which beneficiary earnings exceed the base income, these higher Part B premiums are from 30% to 70% higher with the highest premium paid by individuals earning more than $ 214,000, or married couples earning more than $ 428,000. This extra amount

2185-477: A monthly bus pass in employee benefits cannot use that benefit to pay for rail travel or a day pass. Discounted (half-fare) cards have different rules for SmarTrip and CharmCard. SmarTrip for seniors and the disabled may only be purchased in person from a Metro agent or authorized sales office, and the person must show ID and for a disabled rider, proof of disability (either WMATA Disabled ID or Medicare card) CharmCard for seniors and disabled are only available from

2300-627: A monthly premium in addition to the Medicare Part B premium to cover items not covered by Original Medicare (Parts A & B), such as the OOP limit, self-administered prescription drugs, dental care, vision care, annual physicals, coverage outside the United States, and even gym or health club memberships as well as—and probably most importantly—reduce the 20% co-pays and high deductibles associated with Original Medicare. But in some situations

2415-660: A notice of proposed rulemaking on stored-value cards in the June 28, 2010 edition of the Federal Register . The proposed rules would require sellers of prepaid cards to register with the government and keep records on transactions and customers. Medicare (United States) Medicare is a federal health insurance program in the United States for people age 65 or older and younger people with disabilities, including those with end stage renal disease and amyotrophic lateral sclerosis (ALS or Lou Gehrig's disease). It

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2530-638: A paper or digital ticket in lieu of a credit or debit card through certain DC area employers enrolled in the SmartBenefits program. ***This service is free to all users and does not collect fares. Stored-value card Stored-value cards differ from debit cards , where money is on deposit with the issuer , and credit cards which are subject to credit limits set by the issuer and are connected to accounts at financial institutions. Another difference between stored-value cards and debit and credit cards

2645-410: A patient, regardless of the actual amount of care. The actual allotment of funds is based on a list of diagnosis-related groups (DRG). The actual amount depends on the primary diagnosis that is actually made at the hospital. There are some issues surrounding Medicare's use of DRGs because if the patient uses less care, the hospital gets to keep the remainder. This, in theory, should balance the costs for

2760-536: A provision for additional coverage of skilled nursing care in the indemnity insurance policies they sell or health plans they sponsor. If a beneficiary uses some portion of their Part A benefit and then goes at least 60 days without receiving facility-based skilled services, the 90-day hospital clock and 100-day nursing home clock are reset and the person qualifies for new benefit periods. Hospice benefits are also provided under Part A of Medicare for terminally ill persons with less than six months to live, as determined by

2875-403: A purchase, telecommunication facilities are not needed, which may be important in situations where the availability or reliability of these facilities are uncertain or costly, especially for low-value transactions. A benefit to the merchant is that bank transaction fees are not incurred as the transaction is processed offline and there need not be a reference to the bank for processing. A limitation

2990-569: A special personalized SmarTrip card with the user's photograph and the Metro Access logo appearing on the front of the card. A companion SmarTrip card is included to allow a companion to also ride free along with the disabled person. The first two promotional SmarTrip cards were issued in 2008 to commemorate the opening of the newly built stadium of the Washington Nationals , Nationals Park . Special SmarTrip cards commemorating

3105-1045: A time. In the Metrorail system, using the card to activate the target by will display the value remaining as the faregate opens, both when entering and exiting. On Metrobuses, the farebox will audibly beep and display the remaining value. In all cases, the appropriate fare is deducted automatically, accounting for any applicable transfers and discounts. In an effort to reduce fraud and waste, Metro announced in October 2008 that it would be eliminating paper bus transfers effective January 4, 2009. All riders who wished to take advantage of reduced-fare transfers were required to pay using SmarTrip. Paper bus passes were eliminated in January 2011 and passes are now only available on SmarTrip. For SmarTrip, pass rules are different from CharmCard. All Metrorail passes are now available on SmarTrip. These include One-Day, 7-Day, and 28-Day fast passes valid for unlimited travel on Metrorail. A 7-Day Short Trip Pass

3220-534: A transplant may qualify for Medicare, regardless of age. Individuals diagnosed with ALS are automatically enrolled in Medicare Parts A and B the month their disability benefits begin. Medicare has four parts: Part A, B, C, & D. Coverage under the first two (Parts A and B), as opposed to Part C plans, is referred to as Original Medicare . In April 2018, CMS began mailing out new Medicare cards with new ID numbers to all beneficiaries. Previous cards had ID numbers containing beneficiaries' Social Security numbers ;

3335-487: Is "held harmless" from the 2019 amount if the increase in their SS monthly benefit does not cover the increase in their Part B premium from 2019 to 2020. This hold harmless provision is significant in years when SS does not increase but that is not the case for 2020. There are additional income-weighted surtaxes for those with incomes more than $ 85,000 per annum. Public Part C Medicare Advantage and other Part C health plans are required to offer coverage that meets or exceeds

3450-419: Is agreed upon between the sponsor and the provider. The amounts paid for mostly self-administered drugs under Part D are whatever is agreed upon between the sponsor (almost always through a pharmacy benefit manager also used in commercial insurance) and pharmaceutical distributors and/or manufacturers. Medicare has several sources of financing. Part A's inpatient admitted hospital and skilled nursing coverage

3565-419: Is also sold, allowing unlimited off-peak rides, and unlimited peak rides for trips costing up to $ 3.50, with the difference in fare deducted from the stored value on the card if necessary. CharmCard allows a maximum of two of each pass to be stored, so two day passes and two monthly passes, plus cash, can be stored on the card. Metro also sells SmarTrip cards that are preloaded with a One-Day rail pass online for

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3680-620: Is called the Income Related Monthly Adjustment Amount (IRMAA). Part A —For each benefit period , a beneficiary pays an annually adjusted: Part B —After beneficiaries meet the yearly deductible of $ 240 for 2024, they will be required to pay a co-insurance of 20% of the Medicare-approved amount for all services covered by Part B with the exception of most lab services, which are covered at 100%. Previously, outpatient mental health services

3795-612: Is designed to be permanent and reloadable; the term "SmarTrip" may refer to both payment systems unless otherwise noted. WMATA began using SmarTrip for payment on Metrorail in 1999 followed shortly by Metrobus and Metro parking lots. It was later extended to other public transit systems throughout the region. Although WMATA initially drew criticism due to the limited number of SmarTrip sales locations, distribution has expanded to local convenience stores and supermarkets. By late 2012 all Metrorail stations were equipped with SmarTrip vending machines. In October 2010, WMATA announced that it

3910-761: Is eligible for Part D, which covers mostly self-administered drugs. It was made possible by the passage of the Medicare Modernization Act of 2003. To receive this benefit, a person with Medicare must enroll in a stand-alone Prescription Drug Plan (PDP) or public Part C health plan with integrated prescription drug coverage (MA-PD). These plans are approved and regulated by the Medicare program, but are actually designed and administered by various sponsors including charities, integrated health delivery systems, unions and health insurance companies; almost all these sponsors in turn use pharmacy benefit managers in

4025-478: Is funded by payroll taxes) and premiums paid by beneficiaries. Households that retired in 2013 paid only 13 to 41 percent of the benefit dollars they are expected to receive. Beneficiaries typically have other healthcare-related costs, including Medicare Part A, B and D deductibles and Part B and C co-pays; the costs of long-term custodial care (which are not covered by Medicare); and the costs resulting from Medicare's lifetime and per-incident limits. Originally,

4140-408: Is generally lost and is a windfall gain for the issuing merchant. The merchant also obtains a windfall gain if a card has an expiry date and the cardholder fails to use the full value by that date. Furthermore, the merchant has an interest-free use of the value until it is redeemed. Semi-closed system prepaid cards are similar to closed system prepaid cards. However, cardholders are permitted to redeem

4255-457: Is generally not appropriate; payment such as is approved will be paid under Part B. The time a patient spends in the hospital before an inpatient admission is formally ordered is considered outpatient time. But, hospitals and physicians can take into consideration the pre-inpatient admission time when determining if a patient's care will reasonably be expected to cross two midnights to be covered under Part A. In addition to deciding which trust fund

4370-644: Is identical to the standard SmarTrip except that the card is printed in shades of bright yellow and brown, instead of blue and green. Since the Senior SmarTrip allows for discounted fares, the card may only be purchased in person with a valid ID from a Metro sales office or authorized vendor. On March 27, 2016, Metro unveiled a new SmarTrip card design, to celebrate the 40th anniversary of the Metrorail system opening. Beginning November 2016, MetroAccess cards, which permit use of Metro Access Paratransit and free trips on Metrobus and Metrorail, were replaced with

4485-531: Is in contrast to the Oyster card system on the London Underground , for example, where fares are automatically capped to ensure that customers never pay more than the cost of a one-day pass each day. There have been complaints when customers' cards cease to work as a result of placing the card in proximity to metal or physically damaging the card. In such cases Metro guarantees that the fund balance on

4600-403: Is largely funded by revenue from a 2.9% payroll tax levied on employers and workers (each pay 1.45%). Until December 31, 1993, the law provided a maximum amount of compensation on which the Medicare tax could be imposed annually, in the same way that the Social Security payroll tax operates. Beginning on January 1, 1994, the compensation limit was removed. Self-employed individuals must calculate

4715-506: Is no longer offered as of 2020, but anyone who has a Plan F may keep it. Many of the insurance companies that offer Medigap insurance policies also sponsor Part C health plans but most Part C health plans are sponsored by integrated health delivery systems and their spin-offs, charities, and unions as opposed to insurance companies. Medicare contracts with regional insurance companies to process over one billion fee-for-service claims per year. In 2008, Medicare accounted for 13% ($ 386 billion) of

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4830-405: Is stored on the card itself, not on a network. Therefore, the card must be present to reload it, and when adding the card to a smart device, the card must remain in close proximity to the device during a process in which the data is deleted from the card and stored on the device. This means that once the card is added to a device, the physical card becomes unusable, and only one device can carry it at

4945-443: Is that debit and credit cards are usually issued in the name of individual account holders, while stored-value cards may be anonymous, as in the case of gift cards . Stored-value cards are prepaid money cards and may be disposed when the value is used, or the card value may be topped up, as in the case of telephone calling cards or when used as a fare card . The term closed-loop means the funds and/or data are physically stored on

5060-584: Is that these cards cannot be used for online, telephone, mail order and other " card not present transactions ". The German Geldkarte and the Austrian Quick card can also be used to validate a customer's age at cigarette vending machines . Typical applications of organization specific or industry specific prepaid card include payroll cards , rebate cards , gift cards , cafeteria cards and travel cards and U.S. based health schemes such as HSA cards. The EZpay, EagleCash, and Navy Cash cards are used by

5175-402: Is the same no matter how much or how little the beneficiary paid as long as the minimum number of quarters is reached. Medicare-eligible persons who do not have 40 or more quarters of Medicare-covered employment may buy into Part A for an annual adjusted monthly premium of: Most Medicare Part B enrollees pay an insurance premium for this coverage; the standard Part B premium for 2019 is $ 135.50

5290-463: Is used to pay for these various outpatient versus inpatient charges, the number of days for which a person is formally considered an admitted patient affects eligibility for Part A skilled nursing services. Medicare penalizes hospitals for readmissions . After making initial payments for hospital stays, Medicare will take back from the hospital these payments, plus a penalty of 4 to 18 times the initial payment, if an above-average number of patients from

5405-500: The American Medical Association , advises the government about pay standards for Medicare patient procedures performed by doctors and other professionals under Medicare Part B. A similar but different CMS process determines the rates paid for acute care and other hospitals—including skilled nursing facilities—under Medicare Part A. The rates paid for both Part A and Part B type services under Part C are whatever

5520-585: The Baby Boom generation into Medicare is projected by 2030 (when the last of the baby boom turns 65) to increase enrollment to more than 80 million. In addition, the fact that the number of payroll tax payors per enrollee will decline over time and that overall health care costs in the nation are rising pose substantial financial challenges to the program. Medicare spending is projected to increase from near 4% of GDP in 2022 to almost 6% in 2046. Baby-boomers are projected to have longer life spans, which will add to

5635-535: The Federal Employees Health Benefits Program Standard Option. Some people may qualify to have other governmental programs (such as Medicaid) pay premiums and some or all of the costs associated with Medicare. Most Medicare enrollees do not pay a monthly Part A premium, because they (or a spouse) have had 40 or more 3-month quarters in which they paid Federal Insurance Contributions Act taxes. The benefit

5750-633: The Silver Line . In March 2022, a promotional SmarTrip card was issued to celebrate the National Cherry Blossom Festival . Cards of different designs were also issued in 2023 and 2024. An early criticism of the SmarTrip cards had been that they were only sold at suburban Metrorail stations, online, a few selected retailers, and Metro sales offices. However, in 2008, Metro reached an agreement with CVS/pharmacy to sell

5865-435: The federal budget . In 2016 it was projected to account for close to 15% ($ 683 billion) of the total expenditures. For the decade 2010–2019 Medicare was projected to cost 6.4 trillion dollars. For institutional care, such as hospital and nursing home care, Medicare uses prospective payment systems . In a prospective payment system, the health care institution receives a set amount of money for each episode of care provided to

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5980-421: The 1970s was formalized and expanded under President Bill Clinton in 1997 as Medicare Part C (although not all Part C health plans sponsors have to be HMOs, about 75% are). In 2003, under President George W. Bush , a Medicare program for covering almost all self-administered prescription drugs was passed (and went into effect in 2006) as Medicare Part D. The Centers for Medicare and Medicaid Services (CMS),

6095-653: The Affordable Care Act. In 2022, Medicare spending was over $ 900 billion, near 4% of U.S. gross domestic product according to the Trustees Figure 1.1 and over 15% of total US federal spending. Because of the two Trust funds and their differing revenue sources (one dedicated and one not), the Trustees analyze Medicare spending as a percent of GDP rather than versus the Federal budget. The aging of

6210-467: The Blue Line. One exit lane at each station accepts credit card payments through a reader next to the existing SmarTrip card target. WMATA has since announced that it will make at least one credit card exit lane available at all Metro pay-on-exit parking facilities. The following is a list of transit systems that accept the SmarTrip card for payment. The Maryland Transit Administration 's CharmCard uses

6325-735: The DC One Cards. All students who live in the District of Columbia, attend a public, charter, or private school in the District of Columbia, and are between the ages of 5 and 21 are eligible for a Kids Ride Free SmarTrip Card. The Kids Ride Free Card, a normal SmarTrip card with a large silver Kids Ride Free sticker on it, allows students to ride the Washington Metro , Metrobus , and the DC Circulator for free. The DC One Card Program officially terminated on October 1, 2018. On

6440-665: The DC Public Schools " DC One Cards " which are SmarTrip compatible. The new cards serve as both a student identification card and provide reduced or free Metro fares during student commuting hours. The cards are intended to address youth behavior problems in Metrorail stations. In the summer of 2018, the DC One Card Kids Ride Free program was replaced by the SmarTrip Kids Ride Free Program due to difficulties in activating

6555-447: The District of Columbia, the states in the US that require a license include Connecticut, Florida, Illinois, Iowa, Louisiana, Maryland, Minnesota, Mississippi, North Carolina, Oregon, Texas, Vermont, Virginia, West Virginia, Washington, and Wyoming. Note, these states explicitly require licensing for card issuers. Other states may have more subtle licensing laws. Under 18 USC section 1960, it is

6670-524: The MTA reduced fare office at 6 St. Paul Street in downtown Baltimore, with similar requirements (proof of age or disability). Also, while WMATA charges a $ 2 fee plus the amount to load in value for senior/disabled SmarTrip card, MTA merely requires at least $ 2 in value to be initially loaded onto a senior/disabled CharmCard; MTA waives any fee for the card. " Exit fare " machines (used with paper farecards) previously did not accept SmarTrip, and riders with insufficient value to pay their fare were allowed to exit

6785-646: The Medicare Board of Trustees to assist them in assessing the program's financial health. The Trustees are required by law to issue annual reports on the financial status of the Medicare Trust Funds, and those reports are required to contain a statement of actuarial opinion by the Chief Actuary. The Specialty Society Relative Value Scale Update Committee (or Relative Value Update Committee; RUC), composed of physicians associated with

6900-526: The Medicare program over their lifetimes, and how much someone living to the statistically expected age would expect to receive in benefits. They found differing amounts for the different scenarios, but even the group with the "worst" return on their Medicare taxes would have concluded their working years with $ 158,000 in Medicare contributions and growth (assuming annual growth equal to inflation plus 2%) but would receive $ 385,000 in Medicare benefits (both numbers are in 2013 inflation adjusted dollars). Overall,

7015-1188: The Netherlands, Geldkarte in Germany, Quick in Austria, Moneo in France, Proton in Belgium, Carta prepagata ("Prepaid card") in Italy, FeliCa -cards such as Suica in Japan, China T-Union in mainland China, EZ-Link and NETS (CashCard and FlashPay ) in Singapore, Papara Card in Turkey, Octopus card in Hong Kong, SUBE card in Argentina, T-Cash in the Philippines and Touch 'n Go and MyRapid Card in Malaysia. The U.S. Department of

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7130-487: The Patient Protection and Affordable Care Act of 2010 as amended. The Social Security Administration is responsible for determining Medicare eligibility, eligibility for and payment of Extra Help/Low Income Subsidy payments related to Parts C and D of Medicare, and collecting most premium payments for the Medicare program. The Chief Actuary of the CMS must provide accounting information and cost-projections to

7245-404: The SmarTrip payments, with the goal of an open payment system working with contactless credit cards, government IDs, new transit cards, and more. However, the pilot was terminated and the full proposal was cancelled due to lower-than-expected mobile payment adoption and budget constraints. Instead, in 2018, WMATA announced that contactless mobile payments would be coming to Metro, this time through

7360-550: The Treasury manages three stored-value card programs: EZpay, EagleCash , and Navy Cash. Non-government stored-value cards include Aramark GuestExpress, Compass Zipthru, and Freedompay FreetoGo. Stored-value cards are most commonly used for low-value transactions, such as transit system farecards , telephone prepaid calling cards , cafeterias , or for micropayments in shops or vending machines. They also have an advantage over most other payment cards in that when making, say,

7475-425: The U.S. military as electronic alternatives to cash in areas characterized by difficult access and limited banking or telecommunications infrastructure. Stored-value cards can save organizations a considerable amount of money if customers add a large sum of funds at one time to the card and then pay a lower transaction fee for each use of the card on smaller purchases. Closed system prepaid cards are cards issued by

7590-418: The US average rate. Part A fully covers brief stays for rehabilitation or convalescence in a skilled nursing facility and up to 100 days per medical necessity with a co-pay if certain criteria are met: The first 20 days would be paid for in full by Medicare with the remaining 80 days requiring a co-payment of $ 204 per day as of 2024. Many insurance group retiree, Medigap and Part C insurance plans have

7705-482: The antennas on all Metrorail faregates to improve the speed and range of its faregates' SmarTrip processing. On September 1, 2020, Apple and WMATA enabled SmarTrip cards to be added to Apple Pay through the Wallet app. Later on June 8, 2021, Google Pay on Android devices became supported as well. In May 2011, WMATA and the District of Columbia Department of Transportation started a pilot project to give students in

7820-503: The beneficiary has 60 days continuously with no payment from Medicare for hospital or Skilled Nursing Facility confinement. Some "hospital services" are provided as inpatient services, which would be reimbursed under Part A; or as outpatient services, which would be reimbursed, not under Part A, but under Part B instead. The "Two-Midnight Rule" decides which is which. In August 2013, the Centers for Medicare and Medicaid Services announced

7935-511: The benefits are more limited (but they can never be more limited than Original Medicare and must always include an OOP limit) and there is no premium. The OOP limit can be as low as $ 1500 and as high as but no higher than $ 8000 (as with all insurance, the lower the limit, the higher the premium). In some cases, the sponsor even rebates part or all of the Part B premium, though these types of Part C plans are becoming rare. Medicare Part D went into effect on January 1, 2006. Anyone with Part A or B

8050-439: The card and $ 8 fare value), while those purchased online cost either $ 10 or $ 30 ($ 2 for the card and $ 8 or $ 28 fare value). The cards can be reloaded using farecard vending machines or using cash at fareboxes onboard buses. Until 2016, riders could also add value to their SmarTrip cards by trading in paper farecards (a used farecard up to $ 20, or an unused farecard of any value). There is a difference between SmarTrip and CharmCard on

8165-465: The card will be transferred to a new card. However, customers have complained that WMATA has not been processing such balance transfers promptly. After reports of widespread theft by employees of Metro's parking contractor, Penn Parking, WMATA announced that as part of a new cashless parking payment system, SmarTrip would be the only way to pay for parking at Metro-operated garages and lots effective June 28, 2004. The decision prompted complaints that Metro

8280-428: The cards at 187 DC-area locations in an effort to increase SmarTrip use. The SmarTrip cards are also sold at area grocery store chains. In late 2012 WMATA installed SmarTrip vending machines at all Metrorail stations. A number of SmarTrip features that were supposed to be introduced in 2005 by SmarTrip's creator, Cubic Transportation Systems, were not fully implemented until 2012. Initially, riders could only add value to

8395-405: The cards at multiple merchants within a geographic area. These types of cards are issued by a third party, rather than the retailer who accepts the card. Examples include university cards and mall gift cards. The laws governing these types of cards are unsettled. Depending on the state, the issuer may or may not be required to have a money transmitter license or other similar license. In addition to

8510-618: The conditions with the highest readmission rates were congestive heart failure, sepsis , pneumonia, and COPD and bronchiectasis . The highest penalties on hospitals are charged after knee or hip replacements, $ 265,000 per excess readmission. The goals are to encourage better post-hospital care and more referrals to hospice and end-of-life care in lieu of treatment, while the effect is also to reduce coverage in hospitals that treat poor and frail patients. The total penalties for above-average readmissions in 2013 are $ 280 million, for 7,000 excess readmissions, or $ 40,000 for each readmission above

8625-435: The contract for the new system was awarded to Accenture . In May 2012, the transit agency announced the launch of a new generation of SmarTrips cards after the manufacturer stopped producing the earlier generation. The new cards operate and appear identical to customers except for being slightly thinner and cheaper to produce. The newer generation cards can be identified based on serial numbers beginning with "0167". SmarTrip

8740-407: The country with money that is stored on cards, and (unlike cash in high amounts) does not have to be reported to customs or any other authority. Some members of the U.S. Congress are considering creating laws that would require travelers crossing, entering, or leaving the country to report these cards. The Financial Crimes Enforcement Network of the U.S. Department of the Treasury has published

8855-431: The emergence of closed system prepaid cards has blurred the applicability of APL. North Carolina and Illinois have excluded these types of cards from APL provided the card has no expiration date or a service fee. Maine and Virginia require the issuer to pay the state when the cards are abandoned. In Connecticut an issuer is required to identify the residence of the gift card owner. Since most merchant gift cards are anonymous,

8970-403: The employer is registered with, so an employer who is registered to provide transit benefits with WMATA will only grant benefits usable on WMATA and Washington, DC-area transit providers, even if the benefits are loaded on a CharmCard. Cash loaded on either card is valid on both WMATA and MTA vehicles. This also means purse funds cannot be used for cash equivalents, so a person who is authorized for

9085-418: The entire 2.9% tax on self-employed net earnings (because they are both employee and employer), but they may deduct half of the tax from the income in calculating income tax. Beginning in 2013, the rate of Part A tax on earned income exceeding $ 200,000 for individuals ($ 250,000 for married couples filing jointly) rose to 3.8%, in order to pay part of the cost of the subsidies to people not on Medicare mandated by

9200-530: The entire United States health care delivery system and not just to Medicare. U.S. citizens or permanent residents who have lived in the U.S. for at least five continuous years are eligible. Those who are 65 and older who choose to enroll in Part A Medicare must pay a monthly premium to remain enrolled in Medicare Part A if they or their spouse have not paid the qualifying Medicare payroll taxes. There are some instances where U.S. citezens might be able to enroll in Medicare earlier than age 65. For example, if you have

9315-525: The first recipients of the program. Before Medicare was created, approximately 60% of people over the age of 65 had health insurance (as opposed to about 70% of the population younger than that), with coverage often unavailable or unaffordable to many others, because older adults paid more than three times as much for health insurance as younger people. Many of this group (about 20% of the total in 2022, 75% of whom were eligible for all Medicaid benefits) became "dual eligible" for both Medicare and Medicaid (which

9430-563: The following protected classes of drugs: anti-cancer; anti-psychotic; anti-convulsant, anti-depressants, immuno-suppressant, and HIV and AIDS drugs). The plans can also specify, with CMS approval, at what level (or tier) they wish to cover it, and are encouraged to use step therapy . Some drugs are excluded from coverage altogether and Part D plans that cover excluded drugs are not allowed to pass those costs on to Medicare, and plans are required to repay CMS if they are found to have billed Medicare in these cases. No part of Medicare pays for all of

9545-635: The forecasting of Medicare Trust Fund health and spending trends including but not limited to the Covid pandemic, the overwhelming preference of people joining Medicare this century for Part C, and the increasing number of dual eligible (Medicaid and Medicare eligibility) beneficiaries. In 2013 the Urban Institute published a report which analyzed the amounts that various households (single male, single female, married single-earner, married dual-earner, low income, average income, high income) contributed to

9660-560: The front of the standard SmarTrip card is a stylized picture of a Metrorail car and Metrobus in front of representations of the Washington Monument , United States Capitol , and stylized versions of classical architecture found in Washington, D.C. The Metro logo appears in the bottom left. A "Senior" SmarTrip is also available that automatically calculates applicable discounted fares for senior citizens (age 65+). The design

9775-513: The future Medicare spending. In response to these financial challenges, Congress made substantial cuts to future payouts to providers (primarily acute care hospitals and skilled nursing facilities) as part of PPACA in 2010 and the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and individual Congresspeople have offered many additional competing proposals to stabilize Medicare spending further. Many other factors have complicated

9890-637: The groups paid into the system 13 to 41 percent of what they were expected to receive. Cost reduction is influenced by factors including reduction in inappropriate and unnecessary care by evaluating evidence-based practices as well as reducing the amount of unnecessary, duplicative, and inappropriate care. Cost reduction may also be effected by reducing medical errors, investment in healthcare information technology , improving transparency of cost and quality data, increasing administrative efficiency, and by developing both clinical/non-clinical guidelines and quality standards. Of course all of these factors relate to

10005-487: The hospital are readmitted within 30 days. These readmission penalties apply after some of the most common treatments: pneumonia , heart failure , heart attack , COPD , knee replacement , and hip replacement . A study of 18 states conducted by the Agency for Healthcare Research and Quality (AHRQ) found that 1.8 million Medicare patients aged 65 and older were readmitted within 30 days of an initial hospital stay in 2011;

10120-460: The inauguration of President Barack Obama were issued in January 2009 and 2013. In July 2013, a special July 4 commemorative SmarTrip card was introduced. In June 2014, Metro celebrated the 125th anniversary of the National Zoo by issuing commemorative SmarTrip cards featuring "popular zoo baby residents." In July 2014, a commemorative SmarTrip card was issued to celebrate the opening of

10235-502: The issuing system for that benefit, so a day pass issued by MTA on either a CharmCard or SmarTrip will only be valid on MTA, and a WMATA-issued monthly pass will not be valid on MTA even if it was loaded on a CharmCard. This does mean it is possible to have identical or different passes (like a monthly pass from one and a day pass from the other) from both WMATA and MTA simultaneously loaded on the same card. Monthly transit benefits provided by an employer will only be valid for whichever system

10350-727: The leadership of President Lyndon Johnson , Congress enacted Medicare under Title XVIII of the Social Security Act to provide health insurance to people age 65 and older, regardless of income or medical history. Johnson signed the Social Security Amendments of 1965 into law on July 30, 1965, at the Harry S. Truman Presidential Library in Independence, Missouri . Former President Harry S. Truman and his wife, former First Lady Bess Truman became

10465-435: The maximum value that can be stored on the card: SmarTrip can store up to $ 300 in value, while CharmCard can store up to $ 200. SmarTrip and CharmCard have different qualifications for inter-system usage, e.g. using CharmCard on non-MTA providers, and using SmarTrip on MTA. Passes and non-cash loads (such as employee transit benefits) are stored on the card in a separate "purse" from cash loads. Purse benefits can only be used on

10580-555: The name "Medicare" in the United States referred to a program providing medical care for families of people serving in the military as part of the Dependents' Medical Care Act, which was passed in 1956. President Dwight D. Eisenhower held the first White House Conference on Aging in January 1961, in which creating a health care program for social security beneficiaries was proposed. Various attempts were made in Congress to pass

10695-399: The new ID numbers are randomly generated and not tied to any other personally identifying information . Part A covers inpatient hospital stays. The maximum length of stay that Medicare Part A covers in a hospital admitted inpatient stay or series of stays is typically 90 days. The first 60 days would be paid by Medicare in full, except one copay (also and more commonly referred to as

10810-486: The only payment method accepted on Metrorail; paper farecards are no longer valid. SmarTrip cards are 3 + 3 ⁄ 8 by 2 + 1 ⁄ 8  in (86 by 54 mm), the same size as a credit card or driver's license . The card is brought into close proximity with a circular target on the top or side of each faregate rather than inserted into a slot. Because the card has a radio-frequency identification (RFID) chip inside, it does not need to be touched directly to

10925-617: The option of payments to health maintenance organizations (HMOs) in the 1970s. The government added hospice benefits to aid elderly people on a temporary basis in 1982, and made this permanent in 1984. Congress further expanded Medicare in 2001 to cover younger people with amyotrophic lateral sclerosis (ALS, or Lou Gehrig's disease). As the years progressed, Congress expanded Medicare eligibility to younger people with permanent disabilities who receive Social Security Disability Insurance (SSDI) payments and to those with end-stage renal disease (ESRD). The association with HMOs that began in

11040-477: The patient's physician. The terminally ill person must sign a statement that hospice care has been chosen over other Medicare-covered benefits, (e.g. assisted living or hospital care). Treatment provided includes pharmaceutical products for symptom control and pain relief as well as other services not otherwise covered by Medicare such as grief counseling . Hospice is covered 100% with no co-pay or deductible by Medicare Part A except that patients are responsible for

11155-481: The remaining costs by taking additional private insurance (medi-gap insurance), by enrolling in a Medicare Part D prescription drug plan, or by joining a private Medicare Part C (Medicare Advantage) plan. In 2022, spending by the Medicare Trustees topped $ 900 billion per the Trustees report Table II.B.1, of which $ 423 billion came from the U.S. Treasury and the rest primarily from the Part A Trust Fund (which

11270-411: The residence of the card's owner is deemed to be the state's treasurer's office. Presently, no law requires a merchant to provide refunds for lost or stolen cards. Whether a refund is possible is specified in an issuer's cardholder agreement. In addition, most closed system cards cannot be redeemed for cash. When a cardholder redeems all but an insignificant portion of the card on merchandise, that amount

11385-453: The same price as just the pass alone ($ 14 since July 1, 2012), including all of the commemorative SmarTrip cards issued since 2009. Standard cards can be purchased at vending machines within all Metrorail stations, at Metro sales offices, selected retail stores, and online. The purchase price includes $ 2 for the card itself plus an initial fare value, which varies depending on where they are purchased: cards purchased at stations cost $ 10 ($ 2 for

11500-408: The same services as Parts A and B, usually with additional benefits. In 2022, Medicare provided health insurance for 65.0 million individuals—more than 57 million people aged 65 and older and about 8 million younger people. According to annual Medicare Trustees reports and research by Congress' MedPAC group, Medicare covers about half of healthcare expenses of those enrolled. Enrollees cover most of

11615-456: The same way as they are used by sponsors of health insurance for those not on Medicare. Unlike Original Medicare (Part A and B), Part D coverage is not standardized (though it is highly regulated by the Centers for Medicare and Medicaid Services). Plans choose which drugs they wish to cover (but must cover at least two drugs in 148 different categories and cover all or "substantially all" drugs in

11730-588: The standards set by Original Medicare but they do not have to cover every benefit in the same way (the plan must be actuarially equivalent to Original Medicare benefits). After approval by the Centers for Medicare and Medicaid Services, if a Part C plan chooses to cover less than Original Medicare for some benefits, such as Skilled Nursing Facility care, the savings may be passed along to consumers by offering even lower co-payments for doctor visits (or any other plus or minus aggregation approved by CMS). Public Part C Medicare Advantage health plan members typically also pay

11845-660: The system with any negative balance. This negative balance must, however, be paid before the card may be used again to enter the system. In addition, the card must contain sufficient value to pay the full fee in order to exit a Metro parking lot. Since SmarTrip owners were allowed to exit the system with an unlimited negative balance, the Metro Board had previously rejected proposals to reduce the price of SmarTrip cards from $ 5 down to $ 2.50. Starting September 1, 2012, Metro began offering $ 3 rebates to customers who registered their cards online after purchase. The cards still cost $ 5, but

11960-411: The target, just held near it; thus the card can be scanned while still inside a wallet or purse passed over the target, affording some speed and convenience over the paper farecards which were physically inserted into a slot. Unlike some systems in which only the card number is stored on the chip and is linked to an account on a network which contains the remaining value, in this system, the remaining value

12075-601: The token or card in the form of binary-coded data. This is unlike payment cards where data is maintained on the card issuer's computers. Like payment cards, value can be accessed using a magnetic stripe , chip or radio-frequency identification (RFID) embedded in the card; or by entering a code number, printed on the card, into a telephone or other numeric keypad . There is no common name for stored-value cards, which are country or company specific. Names for stored-value cards include APPH in US, Mondex in Canada, Chipknip in

12190-484: The unique identifier is not linked to a person's name or identity, unless one registers the card online. Registering SmarTrip cards allows riders to recover their remaining balance (minus a $ 5 replacement fee), should the card be lost, stolen, or damaged. The unique identifier also allows workers enrolled in the SmartBenefits program, which allows employers to subsidize employee transportation costs tax-free, to credit their monthly benefits to their cards. The SmarTrip system

12305-548: Was begun in 1965 under the Social Security Administration and is now administered by the Centers for Medicare and Medicaid Services (CMS). Medicare is divided into four Parts: A, B, C and D. Part A covers hospital, skilled nursing, and hospice services. Part B covers outpatient services. Part D covers self-administered prescription drugs. Part C is an alternative that allows patients to choose private plans with different benefit structures that provide

12420-433: Was built and designed by Cubic Transportation Systems, Inc. , a subsidiary of San Diego–based Cubic Corporation. As of October 2010 Cubic is reportedly no longer producing the cards. In December 2010, WMATA issued a request for proposals for a replacement system. The new payment system is expected to use federal employee badges and certain smart phones in addition to the stored value cards. In January 2014 WMATA announced that

12535-797: Was covered at 50%, but under the Medicare Improvements for Patients and Providers Act of 2008 , it gradually decreased over several years and now matches the 20% required for other services. They are also required to pay an excess charge of 15% for services rendered by physicians who do not accept assignment. The deductibles, co-pays, and coinsurance charges for Part C and D plans vary from plan to plan. All Part C plans include an annual out-of-pocket (OOP) upper spend limit. Original Medicare does not include an OOP limit. All insurance companies that sell Medigap policies are required to make Plan A available, and if they offer any other policies, they must also make either Plan C available as well. Plan F

12650-487: Was created by the same 1965 law). In 1966, Medicare spurred the racial integration of thousands of waiting rooms, hospital floors, and physician practices by making payments to health care providers conditional on desegregation . Medicare has been operating for almost 60 years and, during that time, has undergone several major changes. Since 1965, the program's provisions have expanded to include benefits for speech, physical, and chiropractic therapy in 1972. Medicare added

12765-519: Was discontinued, and the maximum permitted negative balance upon exit was set at $ 1.50, with riders who would exceed this being required to use the Exitfare machines to add value to their cards. SmarTrip cards comply with the ISO/IEC 14443 Type B standard. A microchip contained within the card stores its value, as well as the rider's most recent entry and exit points, and a unique identifier. However,

12880-640: Was inconveniencing its many customers, including tourists and other infrequent users, who did not own a SmarTrip card. In April 2007, WMATA began testing the use of credit cards to pay for parking at six Metro stations, avoiding the need to pay for parking with SmarTrip cards at those stations. The sites are Anacostia on the Green Line, Shady Grove on the Red Line, Vienna and New Carrollton on the Orange Line, and Franconia-Springfield and Largo Town Center on

12995-415: Was the first contactless smart card for transit in the United States when WMATA began selling SmarTrip cards on May 18, 1999. By 2004, 650,000 SmarTrip cards were in circulation. On November 12, 2002, the first SmarTrip readers were used on Metrobuses. In May 2004, SmarTrip readers were introduced at parking garage gates. In December 2010, 1,800,000 SmarTrip cards were in use. In February 2011, WMATA replaced

13110-478: Was uncertainty over whether this bill would pass the House, however, as White House aide Henry Wilson's tally of House members’ votes on a conference bill that included Medicare “disclosed 180 “reasonably certain votes for Medicare, 29 “probable/possible,” 222 “against,” and 4 seats vacant.” Following the 1964 elections however, pro-Medicare forces obtained 44 votes in the House and 4 in the Senate. In July 1965, under

13225-431: Was working on a replacement card system because the company that makes SmarTrip cards had stopped producing the existing generation. A new generation of the card with modernized chip technology was launched in 2012. Beginning in 2021, the first-generation SmarTrip cards are being phased out as new faregates are installed that do not support the earlier technology. In 2014, WMATA began a pilot program with Accenture to revamp

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