Latest Health Care Cost Numbers from EBRI

The latest Retirement Health Care Costs numbers from EBRI as reported by US News & Reports has been released. It’s great that attention is being directed to this issue and these costs but these numbers may be misleading;

 

What you will pay as a cost for Health all depends on healthy you are, where you live, what your income is and at what age you retire.


The headline to the article is “Couples Need $158,000 for Retirement Health Care Costs” but then continues to report that this number will leaves a couple with only “a 50 percent chance of having enough money to pay for all of their medical expenses throughout retirement” and in order to achieve 90% success rate retired couples should aim to save $271,000”.

 

But what happens if we dig deeper and personalize the case a little bit more?

 

Using HealthView Services’ RetireMark Software we can input information for a healthy 65 year couple who happens to reside in Ohio (the closest state to the National Average in terms of costs) and earns less than $170,000 in income annually.

Our first bit information that we receive is how long each we live, the male will have a life expectancy to 88 & the female’s is 90. We then learn that they will spend roughly $493,000 on their Health Care Costs

This amount includes paying for premiums for a Medicare Part B and D Plan along with enrolling in a MediGap Plan C policy and also covering any other costs that may arise, like dental, vision, hearing etc….. This number is also expressed in today’s dollars and is earning 0%.

 

If they expect a 4% rate of return on the investments earmarked for Health Care Costs throughout their retirement then they will need about $280,000 at retirement to cover these expenses
But what happens if that same couple has some unhealthy conditions along with everything else being the same?

 

Say like, the male has High Cholesterol and the female has Type II Diabetes.

 

We initially learn from Retiremark that his life expectancy drops to 85 and hers drops as well, to 82. Next, we learn that their total Health Care Costs will fall to to $314,000 (this happens due to their life expectancies being lower) and that they will need about $203,000 at retirement to cover these costs ( as long as the monies earmarked for Health Care earn 4% throughout retirement).

 

Now, let’s just move this couple to Florida from Ohio while having their income stay below $170K and their health revert back to being healthy.

 

The outcome?

 

The amount spent on Health Care will rise to $526,000 and they will need just over $298,000 at retirement. An increase of roughly  6.5% in total increases for what will be spent and what will be need to fund there Health Care
And if we change it up even a little bit more and have the couple earn over $214,000 while being healthy & residing in Ohio, the outcome?

 

They will spend $700,000 for the EXACT SAME COVERAGE throughout retirement & will need $395,000 at retirement that has to earn 4% for the rest of their lives
To repeat again, it’s great that EBRI & US News & Reports are writing about these unspoken costs retirees face but to paint a broad brush over a topic with many variables may be considered misleading.
What has to be realized is that health care costs will have an extremely wide range for retirees and these costs will be based not on only when someone wants to retire but on what their health conditions are, what their income is and alsowhere they live.

 

In this day in age where retirement has become so focused on the exacts that are going to be needed, like how much for food, clothing, taxes & estate why are we will still using extremely broad averages to address something so important as our own personal health?

 

Tracking Longevity

Life & Health Advisor magazine interviews Ron Mastrogiovanni, founder of HealthView Services about the new role health care
will play in retirement and how it must be balanced with the emerging new realities of the retirement income picture.

Read Full Article »

Restless in Retirement

It might sound oxymoronic to think about “working in retirement” yet more than 75% of us expect to work in retirement per a recent study by Merrill Lynch and nationally recognized gerontologist, author, and President of Age Way, Ken Dychtwald.  Working in retirement can put a little extra folding money in your pocket.  It can keep you engaged.  It can provide that basic sense of purpose that is so uniquely American… to be able to answer that cocktail party question, “So, what do you do?”  (Especially for us “Type A” types that never quite got their foot off the throttle!).   Perhaps, for many of us, it is work we always wanted to do for the first time in our lives.  Yet, for others, it isn’t just a lifestyle choice but rather a deep desire to defray living costs-especially health care-and not tap into that nest egg.  With that said, how we work in retirement is taking whole new shapes.  The authors suggest that many of those working in retirement “cycle” through periods of work and a smaller number working on a part-time basis.  This flexibility can allow retirees greater time for leisure activity and also provides the need for people to manage healthcare issues that they or their spouses may face. 

Considering these observations, we recommend a few things to keep in mind as you plan ahead:

Positives

  • Continuing to work could help delay taking your Social Security benefits which may result in higher benefits later on.
  • This income could help you avoid drawing down your investments.  While you may not have a great deal new savings, you will be covering day-to-day costs.
  • Employers may offer healthcare.  If either you or your spouse is under 65 for a child under 26 years old could be of significant benefit.

Watch Items:

  • If you are collecting Social Security, working may impact your benefits.
  • The additional income could impact your tax bracket.  Traditional financial and tax planning might not always take this into account.
  • Start planning specifically for health care costs along with general expenses in retirement.

The contents of this site, such as text, graphics, images, and any other material contained on site are for informational purposes only.  Always seek professional advice for your personal situation.

 

Should I Pay Off My Mortgage?

Just about every three weeks an article pops up somewhere telling us what to do about our mortgages.  Pay it off?  Keep it?  Earlier this month, the Wall Street Journal’s web page had an article by June Fletcher asking the same question.  Given the vignette provided, she said, “Yes!”  And, while for the most part, I agree.  In the tradition of economists and lawyers, the general answer I want to share today is: “It depends”.  It might feel serene to be debt free, especially of the mother of all debts-one’s mortgage-but there are a few watch items.  Here are a few pluses and minuses in thinking through this perennial question:

Positives

-If you are thinking about ratcheting down your income. For example: if you or your spouse expects to retire in the next year or two, maybe you want to see your “run rate” expenses come down.

-If your investments are performing less than the interest you are paying, then it might make sense to pay it off.

-If your rate is high and you cannot refinance to the current low rates due to low income sources cost effectively.

Watch Items:

-If you pay off your mortgage, have you used up your “dry powder” for emergencies?  You could find yourself “house rich and cash poor”. 

-You lose any tax deduction available on your mortgage interest (assuming you are in an early stage of your mortgage.  As you pay it off, a greater portion of your payment shifts from interest to principal, which is not deductible.)

-If you lose your income, you might not be eligible for a mortgage in the future…even if you have hundreds of thousands of dollars in assets.  Banks are looking to ensure you have a steady income flow to support your debt.

-If your interest rates are low, i.e. under 5%, you will be enjoying some of the cheapest money in the past forty years.  As of today, Freddie Mac reports 30 year fixed mortgages at 4.27%, the lowest in recorded history.

I am a big proponent of being debt free; however ,the best choice isn’t always the obvious one. 

 

Study Shows Folic Acid Does Not Prevent Heart Disease

It is a widely accepted belief that folic acid reduces a person’s risk for cardiovascular disease. This notion is so prevalent that according to the Center of Disease control and Prevention, one-third of Americans currently takes a multi-vitamin that contains folic acid. However, a recent study published in the Archives of Internal Medicine conclusively proves that folic acid does not prevent heart disease.

Folic acid is an artificial version of folate, which is a type of B-vitamin that has been shown to correlate with blood levels of the amino acid homocysteine, a protein that has been linked to heart disease. Doctors hypothesized that taking folic acid could ward off cardiovascular problems by lowering the amount of homocysteine in the blood. However, these conjectures had not definitively been proven.

A group of scientists from North American and the United Kingdom undertook a large-scale study that covered eight different trials consisting of 37,500 people who had, or were at risk for, cardiovascular illness. The researches gave half of the participants between .8 to 40 milligrams of folic and the other half a placebo over five years.

At the conclusion of the study, the scientists found that there was a negligible difference between the two groups' heart health. The group that was given the supplement had a 25% reduction in their homocysteine level, yet had no significant decrease in the occurrence of heart disease. The supplement group had an 11.4% rate of having a heart attack, whereas the placebo group had an 11.1% rate of occurrence. The risk of stroke hovered just above 4% for both groups. The researchers concluded that folic acid has no measurable effect on heart health.

The study’s organizers believe these results have debunked the myth of folic acid and discredited homocysteine as an accurate gage of future heart health. According to head researcher Dr. Robert Clarke, “The results are definitive and it is unlikely that any further trials will be set up to address this question.”

However, this doesn’t mean you should avoid it. Folic acid is found in green vegetables and grain products that are good for your heart and are an important part of maintaining a healthy diet. Moreover, it is beneficial for people with specific condition, especially women who are expecting, as it is vital for cell growth.

Folic acid isn’t a magic supplement that prevents heart disease. The most reliable and proven way to avoid heart attacks and stroke is to be committed to a healthy lifestyle and regularly see a physician.  

 

Back to School

Apparently, rising unemployment is hitting everybody.

According to an article in USA Today, nearly one quarter of
retirees are searching for employment—and finding little success.  Traditionally, pensions, coupled with
conservative investments, guaranteed retirees at least a modicum of confidence
as they entered their golden years. However, rising healthcare costs and the
market downturn are just some of the reasons why Americans who had envisioned a
well-deserved respite after years of toil are now being forced to re-enter the
workplace. There are some measurable advantages to going back to work.  Gaining health benefits at a part-time
job can offset some of those unforeseen healthcare costs that inevitably occur
as we age.  (Of course, earnings
can offset Social Security, so one should consult an advisor.)  There is also a certain a level of
enrichment in being a valued member of an organization.  The problem is that after long careers
in particular industries, retirees are finding it difficult to transfer their
skill sets into the few jobs available, especially in the technology
sector.  So what is one to do?

Maybe Rodney Dangerfield had the right idea.

Going to college is a daunting challenge even for the most ebullient
18-year-old freshman, so how can someone who has been out of the classroom for
decades be expected to compete?

How does free sound? (Or at least cheap…)

That’s right.  
Many colleges and universities offer discounted tuition rates for senior
citizens, including participation in certificate programs.   Professors will also often allow
seniors to “audit” classes: that is, acquire the knowledge without having to do
the required assignments.  This is
a good way for some to test the waters before diving into a demanding program.

While I don’t foresee a slew of senior fraternities popping
up on college campuses across the country, starting a second career after
retirement isn’t so farfetched.  In
fact, since American life expectancy is projected to increase over the next
several decades, it may become more commonplace than you think.

Without a Choice

A report in the Boston Herald yesterday cited that
Medicare Advantage Plans will soon be extinct in Massachusetts, and over
200,000 elderly subscribers will have to re-evaluate their Medicare options.

Medicare Advantage, formerly know as Medicare Plus
Choice (and also Medicare part C) is a private insurance plan, designed like
traditional Health Maintenance Organizations (HMO) that provides almost the
same coverage as Medicare Parts A and B at a lower cost. Subscribers enjoy some flexibility
in these programs, as opposed to the clearly defined parameters of Parts A and
B, but while the initial savings may be attractive, some referrals and
“in-network” restrictions can apply.
There are also some considerable disadvantages and complexities to the
program. Subscribers are
responsible for 100% of cost for out-of-network doctor visits, and some
specialists may not be covered.

Despite some unpredictability, over 11 million
Americans are currently enrolled in Medicare Advantage Plans and seem satisfied
with their performance. However,
with the inevitable shifting of current government healthcare distribution to
make way for the new legislation, it is likely that this option will soon be
reduced to levels of inefficacy or eliminated altogether.

New Alzheimer’s Study Sheds Light

A recent report found that spinal taps can precisely
diagnose Alzheimer’s in people who are experiencing considerable memory loss. In
addition, the researchers believe that spinal tap testing may also be able to
predict whether a person with no symptoms will eventually develop the disease.
These findings mark an important step in our understanding of this devastating
cognitive disorder and provide clues into possible treatments and management
techniques.

The study was published in the Archives of Neurology and is ground breaking in that it presents
proof that spinal taps are one hundred percent accurate in determining whether
a person will have Alzheimer’s. The study examined more than 300 hundred
patients in their seventies. Among this group were people who had normal memory
retention, were experiencing difficulties with memory loss, and those who had
ongoing Alzheimer’s. These various patients had their spinal fluid analyzed for
amyloid beta and tau, proteins that are known to accumulate in the dead and
dying nerve cells in the brain.

Researchers found that almost all the patients with
Alzheimer’s had the anticipated protein levels. Among those with memory loss,
nearly 75% had the characteristic protein pattern and every one of these
patients went on to develop the disease within the next five years.  Approximately one-third of the patients
with no symptoms also had the indicative spinal fluid makeup, and the
scientists believe these people will eventually have Alzheimer’s.

The treatment of Alzheimer’s has been unguided and
ineffective due to a crippling lack of information about the disease. Recently,
however, there have been a slew of studies that have provided much needed
insight into the disorder, including this most recent report. The more
information we have, the more likely a care options or maybe even medicinal
strategies can be developed. A disease that has been untreatable could become
manageable.

To this end, the spinal tap study is important because it
confirms that protein buildup in the brain is likely the source of the disease.
Therefore, medications that prevent this scenario could treat the disorder.
However, not enough is known about the role of these proteins in normal brain
performance to confirm this plan of action. More testing needs to be done in
order to better understand this correlation between protein levels and memory
loss.

It is unclear how these findings will be incorporated into
the medical field. It is believed that Alzheimer’s starts to develop
approximately ten years before it culminates in a diagnosis. The spinal tap
test would allow doctors to diagnosis patients in the early stages and test
various treatments. However, there are ethical questions involved. What is the
merit of diagnosing patients with a degenerative disease that is currently
untreatable? When should doctors test for the disease? Also, the accuracy of
spinal taps varies according to the doctor and the lab; how will these
differences be taken into account?

Though more testing needs to be done in order to determine how
spinal taps should utilized, it is clear that this breakthrough has provided
much needed insight into this devastating disease. 

A Course of Action

A friend of mine asked me an interesting question as I was diving into my second course during dinner last Sunday, and I decided that our discussion on the topic might be of
interest to many of our readers.

Question: If a client has
several million dollars invested with an advisor who is charging a fee, should
that advisor be using only mutual funds in the portfolio?

Answer: Today, advisors
are licensed to populate portfolios with an array of investment products. In addition to the traditional
vehicles such as stocks, bonds, mutual funds and CD’s, exchange traded funds
(ETF’s), separately managed accounts (SMA’s), enhanced insurance products,
private placements, and derivatives have become more commonplace in recent
years. When it comes to choosing
the proper vehicle for an investor, financial advisors should consider many
factors when it comes to suitability, but approaches should, first and
foremost, be adapted to the client’s investment capital. For instance, an individual with
several million dollars of investible assets provides the advisor with more
flexibility in choosing specifics products than someone with $100,000. Depending on a specific customer
profile, the $100,000 investor is presumably better suited to be positioned
into some combination of mutual funds, ETF’s, insurance products, and cash
equivalents.

Let’s say we are building a portfolio; my first step is to
address the income floor, which segregates assets from the remainder of your
portfolio to be used for basic living expenses in retirement. In this approach, the floor would consist
of some combination of fixed-income products such as laddered treasuries,
short-term corporate bonds, short-term municipal bond funds, and/or an annuity.
The remainder of the portfolio would consist of several “hubs” made up of
mutual funds/ETF’s, and “spokes” made up of individual stocks, bonds/bond funds
and international mutual funds/ETF’s.

Bottom line: Mutual funds
alone are acceptable for an advisor to use in order to populate a multi-million-dollar
portfolio. The real question should be: would this investor be better served (because
of issues such as potential tax exposure) by taking advantage of individual
securities, separately managed accounts and/or insurance products? In reality, when comparing the
performance of one type of investment vehicle to another, the total return
numbers are similar. What is most
important is that, no matter what the product, it is in the best interest of
the consumer to diversify across several investment categories and asset
classes.

So, if you use a fee-based advisor (and don’t forget; a
fee-based advisor is not only responsible for selecting securities, but
managing total cost and ultimately protecting you from significant downturns in
the market), you should feel comfortable having conversations about the
suitability of your portfolio’s investment vehicles on an ongoing basis. It is important to realize that as your
portfolio grows or your objectives change, your advisor should be offering
appropriate products to meet those evolving needs. At the end of the day, the strength of your portfolio is not
only affected by actual products you are invested in, but also in the level of
advice and service you are receiving from your advisor or institution.

First Yoga, Now Yogurt

As a child, I remember my father getting up in the middle of
the night and stumbling over to the medicine chest for a large blue bottle of
white pellets. He would toss a
handful in a glass of water and hand me one to taste. The Brioschi would fizz and tingle in my mouth, and I would
often be left wondering what would possess someone to drink an entire glass of
the volcanic concoction.

Some readers may identify with my father’s symptoms: an
indescribable feeling of panic caused by an inability to swallow; a burning
sensation in chest; a chronically sore throat. These are very often the warning signs of gastroesophageal
reflux disease (GERD) or
acid reflux, as it is commonly referred—a
condition that affects an estimated 60 millions Americans. Some may experience an occasional acute
episode, while others can become debilitated by the condition. There is no shortage of “cures” on the
market—from over-the-counter remedies like Tums and Pepcid to doctor-prescribed
Protonics. There are also plenty
of “secret solutions” that can be purchased online for $29.95 or so (I’ll save
you the trouble: apple cider vinegar).

While the occasional bout of heartburn may seem benign on
the surface, it is the body’s way of communicating that there is something
wrong in the digestive process; the cause is often behavioral, as poor eating
and drinking habits usually initiate or exacerbate the condition. There are literally hundreds of
websites that describe GERD and offer treatment advice, so we will spare you
from retelling what a simple Google search can yield. I will however, share with you my personal tale of how to
cope with the disease without using medication or making major dietary changes.

When I was first diagnosed after a series of tests, including
an upper GI exam, my doctor prescribed Omeprazole. Stand in any grocery line and odds are that someone waiting
to check out either uses, has used, or knows someone who is using
Omeprazole. The idea of being
unnecessarily tethered to a medication that could be eliminated with behavioral
modifications didn’t sit well with me, so I tried a host of touted cures (and
yes, bought the vinegar brochure), changed my eating patterns, and even gave
up—dare I say it—coffee. None of
them worked…

..until I met Chobani.

For those of you who are not familiar with Chobani, it is a
Greek yogurt that contains a dose of probiotics—“good” bacteria that aid in
digestion and maintaining a healthy immune system. After two years of my daily six-ounce cup, I am reflux free
and have been sick only once. Of
course, that bout occurred during a forced three-day sabbatical when my wife
forgot to buy it and I couldn’t get to the store. (We have since reconciled). It is high in protein, low in
carbohydrates, relatively inexpensive, and best of all, tastes much better than
most of the runny blobs in your local dairy aisle.

While GERD is certainly a serious condition and varies in
severity from person to person, those with a mild case may find respite in this
little miracle mousse.Combine it daily with sensible eating habits, a relatively
low-fat, high fiber diet, and exercise, and you might be able to throw away the
medications—and Brioschi—for good.