Medicare and Medicaid – What is the Difference?

Medicare is healthcare for people 65 and older or that have been deemed disabled for at least 24 months by Social Security.  Medicare covers health care aimed at serving an aging population.  Coverage for items like hospitalization, skilled nursing care, home health care, doctor visits, emergency care and more are included in what Medicare covers. Medicare is regulated by the federal government and you can find out more about Medicare here.

Medicaid is health insurance with financial aid and is largely aimed at serving low income mothers, children, and disabled seniors.  Each state has different rules and requirements regarding who may be eligible and what is covered.  You can find out more here.  Medicaid is regulated and funded by the federal and state government but each state is largely in charge of their own program. It is possible to be eligible for both programs at the same time.  We can help you apply now!

What To Do if You Move (With Your Health Insurance or Medicare)

Any time you move, contact your insurance agent no matter what your age to see if you need to change or SHOULD change plans.

Often, your time is limited to do this so it’s important to contact your agent BEFORE you move so they can help you plan. Usually you only have 60 days and if you notify your current plan too soon, there is a chance they could automatically end your enrollment too soon.

DID YOU KNOW?

The USPS postal service is required to let insurers know (health and life insurance know) about a change of address? They are also required to let Social Security know.

If you are on Medicare, or are drawing Social Security, here is how you can easily submit an address change online.  If you are not computer savvy, do not despair, simply call Social Security, at 1-800-772-1213, and they will take your address change over the phone.  

Don’t hesitate to ask us for assistance.  That is why we are here.

Track your Stimulus – Even If You Do Not File Taxes

Customers and I text all of the time.  Usually for fun and friendliness.  However, I often get serious questions via text/sms. Last night a Medicare client sent me this text.

Even if you do NOT file taxes you can track your stimulus check and give the IRS your checking account information.  Just click the link below to go to the IRS website.  Be careful because I have seen scams that pose to be official websites but are just phishing for your personal info. For additional information, contact the IRS directly.

I had to pay and used my checking account to pay electronically and yet I had to click on this link and provide my information after learning the IRS did not have the information they needed according to their tool on the IRS tracking website.

Medicare Coverage & Veterans Benefit

Although it is not absolutely necessary the VA STRONGLY encourages you to sign up for Medicare Part B.  You may also want to consider getting a Medicare Advantage or Supplement plan as well.  This is especially the case for veterans that are NOT in priority group 1.  There is no guarantee that Congress will approve VA funds to treat Veterans for Priority Groups 2-8.

Here are just a few reasons why Veterans may consider enrolling in a private Medicare Supplement or Advantage Insurance Plan:

  • You do not live near a VA facility
  • You are enrolled in one of the VA lower priority groups, and could potentially lose your benefits*
  • Option to use local Doctors and Hospitals
  • Extra Benefits
  • Second opinions
  • Obtain treatment sooner than VA offers
  • Urgent Care (find out more about VA treatment for urgent care here)

Learn more about Medicare & Veteran’s benefits here

Not Enough Information for Retirement

Retirement saving plays an important role in the U.S. economy. Americans hold more than $18 trillion in private retirement accounts like 401(k)s and IRAs, while defined benefit pensions in the private and public sector hold trillions more. Social Security and Medicare comprise nearly 40 percent of the federal budget. The government also provides tax subsidies for retirement saving, and funds Medicaid, which covers elder long-term care. Yet despite existing research, policymakers do not have access to reliable data when making decisions that affect the retirement security of tens of millions of families. There are many major outstanding questions:

  • How well are households preparing for retirement?
  • Why does consumption fall at retirement? Does this indicate that retirees aren’t saving enough, or does it reflect their ability to secure the same quality of life with fewer expenditures?
  • Do tax-based saving incentives raise net wealth accumulation?
  • What policies boost saving? Would improving financial literacy or mandating saving be effective? Are there retirement saving programs that raise participation and increase overall wealth accumulation?
  • Why do households consistently make retirement financing decisions that do not appear to be in their own best interest?

Obtaining better answers to these questions and using the insights they provide to guide changes in the American retirement system could improve living standards for generations of retirees and control the federal budget. But to obtain these answers, researchers and policy makers need better information— that is, more than access to more comprehensive data. They must also employ better study designs. In the absence of such robust studies, it hardly surprising that almost no retirement policymaking is rooted in evidence; programs simply continue indefinitely with little or no Congressional oversight. Federal tax expenditures for retirement saving—which totaled $252 billion in 2018—have never been formally evaluated, while the Social Security Administration devotes less than 1 percent of its administrative budget to research and evaluation.


Making effective evidence-based policy requires both a comprehensive understanding of the policy challenge and attendant remedies, as well as the will and ability to implement the necessary reforms. The federal government should commission a large-scale panel survey that, coupled with linked administrative data, provides detailed information on household wealth, labor market, health and demographic data. No current data set provides such information.

You can find the full Retirement Security Project at Brookings paper here.

Do 40% of Retirees Really Rely on Social Security for Their Entire Income?

AARP reports that Americans are concerned and even afraid for their retirement security. And the news headlines often don’t make them feel better. The latest is a claim from the National institute for Retirement Security that “A plurality of older Americans, 40.2 percent, only receive income from Social Security in retirement.” If true that’s very worrying. But does this frightening factoid hold up?

The NIRS report’s data source is the Census Bureau’s Survey of Income and Program Participation (the SIPP). The SIPP surveys households by asking them a wide variety of questions, including the sources of their income. From the SIPP, NIRS declares that 40.2 percent of retirees receive all of their income from Social Security.

And yet, a 2017 study by researchers at the Social Security Administration, also using the SIPP, found that only 19.6% of Americans 65 and over received at least 90% of their total incomes from Social Security. That’s less than half the share of retirees than NIRS claims and SSA measures dependence using a lower bar—90% of total income rather than NIRS’s 100%. Clearly, there’s a conflict.

Moreover, a second 2017 study, from two Census Bureau economists, analyzed retirement incomes using IRS tax records, which are more accurate than households’ responses to a survey. The Census Bureau study found that only 12% of Americans aged 65+ received 90% or more of their income from Social Security. Again, it’s not clear how that is compatible with NIRS’s claim that over 40% of retirees receive all their income from Social Security.

From a policy perspective, one-fifth of retirees being heavily dependent on Social Security isn’t a huge problem: the poorest fifth of workers are indeed quite poor, and Social Security was designed to provide a retirement benefit for workers who can’t easily save on their own.
You can find the full article, including a discussion of why the NIRS data might be wrong, here.

According to AARP, one in 3 Tennesseans 67 and older are living on Social Security alone. To find out about poverty and the elderly learn more here.

A Real Drug Story

On Friday, I drove to visit some upset clients who have been with me for over six years and are family members of other long time clients. They called me panicked after going to the pharmacy to pick up their medications the first time in 2020. Their prescription costs went from $22 per month in 2019 to $332 in 2020. I had called them a couple times and wrote them between the end of September through the December 2nd. We had spoken and they vowed to look at all the changes to their plan with me and call me back. Frankly, they had a lot going on in their family and had been happy with their plan for years. They figured it was a low priority, considering every other year we went through our review- I hadn’t ever recommended a change. Behind the scenes their 40 year old daughter who suffered from depression had hung herself and left behind three children and two grandchildren. GOOD NEWS in all of this was – they could still change their plan (until MARCH 31). They thanked me profusely for helping them choose a plan that allowed the best of care with minimal out of pocket expense when he went through an organ transplant and she simultaneously suffered from and survived breast cancer. Bottom line -I HELP HEAL AND CARE FOR FAMILIES, not SELL products or insurance.

Medicare Premiums and Deductibles Released for 2020

Here are the highlights of what you need to know:

  • Medicare PART B base premium will be $144.60 ($491.60 for the highest income individuals)
  • $198 is the annual PART B deductible
  • Medicare Part A deductible $1408, up from $1364 (which covers your first 60 days in the hospital)
  • $176 co-pay  PER DAY for skilled nursing care 
  • For those who do not qualify for premium free part A, the premium will be $451 per month

Read more here.

The good news is that you can get a Medicare Supplement that covers most of these costs.  You can also get a Medicare Advantage plan that can save you money and limit your RISK than having original Medicare alone. Find out more here.

Heather Majka creates Citizens Insurance Solutions and is a Sole Proprietor as of June 2019

Heather Majka, formerly Director of Senior Financial Group, starts her own company – Citizens Insurance Solutions.

After 13 great years building infrastructure, writing operational procedures, training agents, building systems, generating leads, and building relationships for someone else, I decided to leave what was once my dream job, to start my own business.  It was definitely long over do that I focus on building relationships and doing things my way.  

I always dreamed of spending more time focusing on relationships and connecting with people and with my former job I had too many demands to really do that.  Now as a sole proprietor I choose what is important and how to spend my time, serving the community!  Join me in ensuring that everyone who asks gets the help they need to cover their healthcare costs, provide peace of mind, focus on health, and feel good about their finances. We make things easy and simple and ensure that everyone knows they deserve protection.

Big Changes in Medicare Advantage and Part D for 2020

This year there are big changes that could cost you $$$$.  I have seen as much as a $35,000 savings just from reviewing the changes in the plan that are not obvious.  Please call or email me and I can help you determine if you are right were you need to be or give you some options to consider if you would like or need be. This 2 minute video explains what I mean and so does this picture below!