Are your elder family care plans realistic?

Are your elder family care plans realistic? 

Usually, a good retirement adviser will ask numerous questions to find out how they can assist the retiring senior family member.  Over and over again, when I ask what plans are in place if you were no longer able to care for yourself, I hear,  "my family will take care of me".  Let's look at some realistic issues usually overlooked when these statements are made.

First of all, we are not just talking about helping mom or dad walk around.  They might not be mobile enough, but then they are not stable enough either for other things.  Not only will they need assistance to the bathroom, but they will need assistance in the bathroom getting up, standing, etc.  Will you be cleaning up after a bowel movement?  Two questions to ask are:  1) Will mom or dad feel comfortable having you play nursing assistant?  2)  Will you feel comfortable with the unspeakable?  If the answer is no to either, then perhaps your plans need a reassessment.

Will you be able to lift mom or dad?  If you are a petite female or a paper-pushing male, you may not be able to pick up dad, or mom, turn them in bed, etc.  Often as their time comes close to its end, seniors become bedridden.  It's something to think about.  Again, if the answer is no, perhaps a family meeting is in order.

Next, who gets to take care of them?  Is the oldest the one elected?  Is there more than one sibling to choose from?  Is it the closest to the parent's house?  Does that individual have children of their own?  Can they afford to take off from work for months to years?  Are they a medical professional, or will they need to learn techniques for changing sheets, supporting an unstable handicapped person, etc?  What changes will the elected sibling have to make in his or her family to take care of mom or dad?

From my own experience, let's look at two scenarios.  First, Dad retired at 65, found out he had colon cancer, and died 6 months later.  In this scenario, mom and my sister made a couple of whirlwind trips to the hospital, followed by relatively short hospital admissions. My sister had one or two kids at the time and owned a business as I recall.  She didn't have too much trouble taking care of business.  In the other scenario, mom went downhill slowly.  By that time my sister had four kids under 10 years of age and my mother was living with her and her husband.  I, on the other hand, the oldest, lived out of town and managed hotels in various locations.  Not only did mom need to go to the doctor a couple times per month, but she was also on dialysis three times weekly.  We finally had to put her in an assisted living facility because the constant care was just too much for one person.

If you know someone who has had to take care of a loved one, just ask them what they encountered.  Hopefully, this will give you some issues to think about or create some for you to think about.  If I can help, contact me.

Why is Medicare alone not enough?

Why is #Medicare alone not enough?

Just as people who were new to Social Security at its inception, many people blindly believe they have enough when they have Medicare as a stand-alone plan.  Truth is Medicare leaves large gaps that it doesn't cover.  These gaps can mean complete financial fall out for someone who as they get older who fall into poor health.  So let us review what Medicare covers, doesn't cover, and how much is your financial responsibility.

First, Medicare only covers what is medicare approved.  Surprised?  Well, you shouldn't be.  Secondly, Medicare only covers what is medically necessary.  So if you think you will be able to get those dental implants, FORGET ABOUT IT!.  Lastly, Medicare will only cover a small portion of skilled nursing.  After the first 20 days, and up to day 100, you have to pay a copay which changes each year.  Post day 100, you pay the ENTIRE AMOUNT. For coverage though, you have to have been in the hospital at a minimum of 3 days, and not out longer than 30.  Plus, in most states, you have to be showing signs of improvement.  I'll explain more below.

What Medicare doesn't cover, is numerous.  The first three pints of blood are not paid for by Medicare.  Neither are custodial and intermediate care.  Finally, it doesn't cover dental, vision, and hearing.

Medicare has four parts. Part A covers your hospital expenses, ie room, board, etc.  Part B covers doctors expenses, ie primary care physician, specialist, and covers inpatient/outpatient visits or surgeries, lab work, durable medical equipment, etc.  Part C whether it is a Medigap plan or you have a Medicare Advantage plan, picks up some to all of what A and B don't cover.  Part D is generally a stand-alone prescription drug plan required if you have a Medigap plan and under certain other situations.

Where do the costs come in?  Under Part A, during every benefit period or a period of 60 days, you pay a deductible.  If you are the type that has to be admitted every 61 days during the year, you could have to pay this deductible up to 6 times.  If you need care beyond this first 60 days, you will have to pay a copay of one amount up to day 90 and then twice that for days 91 to 150.  Also, once you have used up what is known as your lifetime reserves, those days between days 91 to 150, you lose those.  Further charges then become your responsibility.

Under Part B, you have a deductible but you only pay this once per calendar year.  You also are responsible for 20% of any approved Medicare charges.

http://ltc-ab2.info/videos

Finally, if you go to a doctor who doesn't accept Medicare assignment, you will have to pay up to 15% more for extra charges called excess charges they are allowed by Medicare to charge.

Many doctors or ceasing to accept Medicare, which means you are responsible for more and more of the bill.  If you are kept for observation and not admitted, you pay.  Having been discharged, should you need assistance with your activities of daily living, ie walking, feeding, incontinence, etc, you pay.  If you need a skilled professional for further assistance, you pay.  If you need to be admitted to a skilled nursing facility, being released before the qualifiers above, 3 days, you may have to pay for skilled nursing yourself.  At a rate of $150 or more per day, your liability could drain your retirement savings.  Wouldn't it make sense to have a plan in place so you don't ruin your retirement?

Two scenarios might help clarify this lengthy dissertation.  First, you get food poisoning from a local restaurant.  If you only have Medicare you pay the Part A deductible, the Part B deductible, 20% of the doctors' bill, and excess charges if the doctor doesn't accept Medicare assignment.  In the second scenario, you have a hip replacement.  You pay for Part A, and Part B deductible.  Since this takes time to heal, after 3 days you are admitted to a skilled nursing facility.  Due to complications with walking, you have to stay for more than 20 days.  You have to pay for each day you are in there.  Let's say you only stay 10 days but you need intermediate care.  You pay all of this.

While the figures were deliberately left out because they can change yearly, this should give you some idea of the cost to you.  Wouldn't it make sense to invest in your future and protect your life's savings against such unexpected medical emergencies?  For further information, contact me.

Why I do what I do

Before my mother passed, she needed much care.  Not only had she only one kidney, but she was on dialysis.  Sometime in the past, we also believe she had a stroke because one day she woke up behaving differently than normal.  She loss focus over the years after retirement and needed someone to look after her personal affairs.  Someone broke into our childhood home so we were also concerned for her well-being living alone.  As if that wasn't enough, she started to have heart problems.  My sister then took her in when she had four young children and a husband.

Sounds like a wonderful ending, right?  For her, all she had to worry about was her daily affairs such as going to the doctor or dialysis.  The real burden as she began to lose her activities of daily living rested on my sister.  The family wants to say they will take care of their parents when they get old, but when the time comes stark reality hits.  Mom had to have assistance with her incontinence and walking.  We were fortunate that she didn't mind the assistance but some parents are taken off guard or even offended to think one of their children will assist them.  The offspring often have obligations such as jobs and family they have to attend further adding stress to the situation.  Some move miles away over the years.  Then, the reality of cleaning Mom's incontinence, feeding, or bathing is something they may not have considered.  Some just can not provide the necessary care being physically unfit for the task.

We were anything but rich so we did not have a plan for this life-changing event.  Eventually, she needed to be put into a nursing home where someone was available around the clock to assist her walking, bathing, toileting, and eating.  

Today, we find the same care would cost over $143,000.00 annually.  Medicare doesn't pay for that care.  If my parents had a plan in place the cost would not be a problem.  Sadly, many people are just like them.  

They don't have to be.  That is why I like to spread the word.

Then, there is the story behind my dad.  My dad retired at age 65 and then passed the following year.  He started having health problems shortly after retirement but was too stubborn to go to the doctor.  There is the possibility he didn't want to know until after I graduated from college so he would have a clear mind.  Whatever his logic, he was diagnosed with colon cancer.  Back in those days, the more practiced procedure was to remove the infected body parts and wish you luck.  That luck only lasted a short few months before we found cancer had metastasized.  At this point, there was no further hope.

Had I known and the product was available, he could have had a Medicare Supplement to take care of his hospital bills.  People today are ill-informed or worse not informed, so they miss out and have to pay for care themselves.  I can offer a plan to fit any budget and that is why I spread the word.