Senior Care Live: May 23, 2026

Listen in as host Steve Kuker, President of Senior Care Consulting, provides an overview of “how to pay for the high cost of senior care” including Medicare, Medicaid, Long Term Care Insurance, and the VA Aid and Attendance Benefit.  #SeniorCare #SeniorCareLive #SeniorCareConsulting #SeniorLiving #KansasCitySeniorCare #SeniorCarePlacement #SeniorCareAdvisor #Franchise #SeniorCareFranchise #VA #VAAidandAttendance #LongTermCare #Medicaid #Medicare 

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Transcript

Speaker 1 0:01

Are you caring for an aging loved one? Are you a senior searching for answers? Welcome to Senior Care Live, a program dedicated to you providing information, education, and resources for seniors and their caregivers. And now, America's Senior Care Consultant, Steve Kuker.

Speaker 2 0:23

Hello and welcome to Senior Care Live. I'm Steve Kuker, your senior care consultant, and I really appreciate you tuning in today. If you have a seatbelt nearby, you might want to buckle it up because I this is going to be a fire hose type of a program, and I'm going to touch on so many super important issues, but I'm going to start off by talking about the cost of care at the primary levels of care. And then I'm going to break down the various ways to pay for the high cost of senior care. So here we go. How to pay for the high cost of senior care. Before we touch on that, I just need to break down the cost because it's pretty stunning. And if you're driving, keep your hands at 10 and 2. Don't need any , swerving or anything like that. Okay, so I'm just talking about the primary types and levels of care, of senior care. Home care. So if you want to stay home, remain independent in your home. I'm a huge, huge fan of home care. but if it rises to the level of 24 hours a day, it can get a little pricey and it's worth it. I mean, if you have the funds, if you have long-term care insurance, etc , it's absolutely worth it. But a lot of folks, it might be a little too much. So ,, you know, we're looking at about $40 an hour. If you have 24-hour care, that's $960 a day, or on a 30-day month, it's $28,800. And in a year, that's $350,400. Okay, so it costs a lot. Is it worth it? Yep, absolutely. Now the assisted living, so if you move to a community that provides care, then I'll just touch on the three primary levels here. So the assisted living level of care averages $8,000 a month, because I always say the average is six thousand to ten thousand a month. So I just picked the middle number, eight thousand. That's ninety-six thousand dollars per year. And then the average length of stay is two point five years. That means the average person would spend about two and a half years in the assisted living level. So if you did that, you're spending about two hundred and forty thousand dollars. And so we have that number. Long-term care. I just did it for a shared room. A private room is a lot more than this. Shared room, I just took an average of three hundred and twenty-five dollars per day. You can you spend more than that? Yep, you can. These are just some average numbers to set up the next part as far as how to pay for all this stuff. So $325 a day for a shared room. That's in a 30-day month, that's $9,750 a month or $117,000 in a year. The average length of stay in long-term care also happens to be two and a half years. So that means you're spending $292,500 in an average length of stay in long-term care, spending an average amount of $325 a day. Like I said, hands at 10 and 2. So , home plus another , fantastic level of care. I've talked about this many times. I would say it's the high end of the assisted living level of care, but it's in a house. Generally a ranch style house. You could have six or eight or ten, ,, usually up to a max of about twelve residents per household. So it's a fantastic option. I just put an average cost on that at $10,000 a month. That's $120,000 a year. Again, two and a half year average length of stay, and you're looking right at $300,000 that you'll be spending. So how are we going to pay for this? It's all very expensive, obviously. Is it worth it? Yes, and each one of those different levels of care are the perfect fit for a particular person. And you know what? You may need a couple of different levels of care. I spoke with a super nice lady this last week, and she wanted her father to move into assisted living, but was concerned that with his age of 92, what if he needed more care? She didn't really want to move him twice. So we're going to be looking at assisted living that is connected to long-term care. So you may even need a couple of different levels. Maybe you start off with home care in your home, and then at some point you move to assisted living or home plus or long-term care. So , that you could it you could be on the mix and match plan here. So , so I just wanted to set that up. So, how are we going to pay for all this stuff? So there are so many questions about all of this. I went to a meeting, a group meeting with a fantastic group , last weekend, and all of these questions started coming up, and I'm like, people don't really know this information, and it's so valuable. And , if you know me, you know this. If I if I'm hearing about this, or if a lot of people have the same question, I feel that nudge to share it with you over the air here, and of course then on the podcast after it airs, after the broadcast airs. But let's start off by , talking about Medicare. This is wildly misunderstood. I can't tell you how many times I have met with , a family or individuals, and we're going to need assisted living or long-term care, whatever it is. And they're like, Steve, we're in fantastic shape. I have the best Medicare policy that money can buy. And so I'm ready to use that to help me pay for my care. And I'm like, oh boy. I'm I hate to be the bearer of bad news, but it's not going to pay for that. Well, what do you mean? What do you mean, Steve? Are you sure about that? Oh yeah, I'm sure about that. Let's just talk about this for a minute. And one of these days I'll have my friend Mark Squires, the Medicare whisperer, on to break it down better than I can. But I'm going to give you the basics here. This is how you should look at your Medicare coverage. Your Medicare coverage is essentially health insurance. It pays for medical stuff. If you look at it that way, you can probably answer your own questions about what it pays for. So Medicare is going to pay for hospitalizations, surgeries, doctors' visits, labs, x-rays, MRIs, CAT scans, medications. What is all of that? All of that is medical stuff, right? It's your health insurance, it pays for medical stuff. Now, where I think it gets a little confusing for a lot of folks, well, wait a minute. You know, my mom broke her hip, she went to the hospital, she got a new hip, and then they sent her to the nursing home to get rehab. Now, you just told me it doesn't pay for a nursing home or , assisted living or whatever, but I'm telling you right now, she got care at a nursing home and Medicare paid for it. Yes, but it's for a short time. Medicare will, again, medical stuff. Medicare will pay for a rehabilitation stay in a long-term care community, but only after a hospital stay where you were in the hospital and you were an inpatient being treated for something for at least three midnights. You have to be there long enough to cross three midnights. And again, an example: you have a fall, you have a fractured hip, you go to the hospital, they'll pin your hip back together, they will replace your hip, you're in there three or four days, you've passed the three midnight rule there. And then you automatically qualify, assuming you actually need therapy, and a doctor will write an order for that, and they all will if you need it, for admit to long-term care for rehab, P T O T, physical therapy, occupational therapy. So you'll go to the nursing home, Medicare will pay a maximum of 100 days, and as long as you are still working at it and showing some improvement, they're going to keep on going. The second that you kind of level off in your capabilities, that's called a plateau, or if you get back to your, here's the home run, if you get back to your original capabilities, that's the best possible, best case scenario, then they're going to discharge you. So Medicare will pay for that part of it. The second they discharge you, something needs to happen. You either need to return home, stay there as a long-term care resident, move to assisted living, you have to do something at that point. and you you'll pay for that too, out of pocket. So that's what Medicare is going to pay for. What Medicare does not pay for is home care, right? The non-medical in-home assistance, on an hourly basis, it does not pay for that. It does not pay for assisted living. Medicare does not pay for a long-term care stay in a nursing home. It just not designed to do that. So, and I hate to be the bearer of bad news, but that is the truth. So, coming up next, I'm going to continue the conversation on how to pay for the high cost of senior care. But first, senior care live question of the week. Assisted living averages $6,000 to $10,000 per month. What is the highest monthly cost Steve, that would be me, has heard of in the Kansas City market? A $11,000 a month, B, $12,000 a month, C, $14,000 a month, or D $16,000 a month. What's your guess?

Speaker 1 10:42

You're listening to Senior Care Live on the Senior Care Broadcasting Network. For more information, visit SeniorCareLive.com. We'll have more with Steve coming up next.

Speaker 2 11:01

All right, back to the Senior Care Live question of the week. Assisted living averages six thousand dollars to ten thousand dollars per month in the Kansas City area. What is the highest monthly cost, Steve? That's me, your dear beloved host. What's the highest monthly cost Steve has heard of in the Kansas City market? These are your options. A $11,000 a month, B $12,000 a month, C, $14,000 a month, or D, $16,000 a month. And the answer is C. The answer is C $14,000 a month. I about fell out of my chair. I spoke with one lady, she listens to the program, and I love that by the way. And so many people listen to the program. But she get she calls, she says, Steve, you were talking about assisted living on the on your radio program the other day, and you're talking about like six to ten thousand. We're paying $14,000 a month. Is that does that sound right to you? And I'm like, no, and heck no. So , yeah, that is an outlier. that's the most I've ever heard for the assisted living , level of care. That's crazy. you could get long-term care, which frankly for this person would have been way more of an appropriate fit for their needs for less money. that's how crazy that is. So, okay. Well, let's jump back into how to pay for the high cost of senior care. I do want to put a footnote on that brief Medicare overview. And I think this could also cause some problems. A lot of people say, well, wait a minute, Steve, you're wrong because Medicare paid for , home health care services to come into my mom's house and physical therapy and occupational therapy, and a nurse would stop by once in a while. And then they also see that as they would also pay for that hourly care from a home care provider, that non-medical in-home assistance, and those two things don't go together. Medicare will pay for a Medicare certified home health agency to come in for a brief period of time, and the two big main services for that would be physical therapy and occupational therapy, and they'll come in maybe one to three visits per week, typically 30, 45 minutes, probably an hour max, to help you with physical therapy, occupational therapy. A nurse might come in , to do, maybe a little bit of wound care dressing changes for a short period of time. Typically, that's an eight-week certification period. If you need more help than that, they can recertify for another , certification period. But the bottom line is that is health care. It's health related that's paid for by your health insurance, which is Medicare, and home care, which is a super valuable service on an hourly basis, helping you with all of these activities of daily living. And that that is not paid for by your Medicare policy because that's not health care. Hopefully that is more clear than mud. Okay. Medicaid, I broke this down quite a bit here recently on the program, so I'm just going to touch on a few things here. Medicaid is a federal program, and it is funded with hundreds and hundreds of billions with the B, hundreds of billions of dollars every year. I mean, there is so much money going into the Medicaid program, it is unbelievable. But it isn't like a one size fits all. So, what they do then is they allocate funds to each state. So obviously, a state that has a lot more population is going to get more money than a more sparsely populated state. Obviously, that makes sense. It's a per capita thing. But each state is responsible for how it uses that money. And you could have some slight differences between state, you know, state to state. I gave a rock solid example of that last week. If you want to hear that, go back and listen to the podcast. It was really good. But all of , frankly, all of the rules and regulations, etc., they're all very, very similar. So it pays for long-term care. Or, you know, that's your nursing home stay. It will pay for your daily rate for a long-term stay in long-term care at that nursing home level. it will partially pay, not fully, but partially pay for the assisted living level of care. So, for example, in Kansas, it will not pay for the apartment, the cost of the apartment, but it will pay for, I just call it support services. The assistance that you would receive with your bathing, dressing, grooming, toileting, and continental support, medication management, etc., etc. Okay. Uh it will pay for it may pay for some home care, okay, and I'm not going to get into all of that. There are very few home care providers that are enrolled in the Medicaid program, and it'll pay for you know some of that. It's pretty tough to , get into that, frankly. So, how do you qualify for the Medicaid, , the Medicaid qualification to have that help you pay for your care? And it's essentially an asset test. Okay, so let's just kind of jump into that a little bit. And again, you know, I touched on a lot of this last week, and actually a couple of weeks, but it's an asset test. So you have to take your assets and then divide them into two categories. So one category is an exempt asset, so your house is an exempt asset for now, a car, a prepaid funeral plan, a small amount of cash value, and a life insurance policy, and then all the stuff in your house. So countable assets, just , almost everything else. I like to say, just think liquid assets. And let's say you you're a single person, you add it all up, it the number is fifty thousand dollars, then you would spend that down to five thousand nine hundred and nine dollars in the state of Missouri, two thousand dollars in the state of Kansas. And oh my gosh, I have so many people. Oh, I make too much money to be on Medicaid. Well, maybe not. Probably not, I'll say that. Okay, so you're down to 5909 in Missouri, 2000 in Kansas, boom, you are in. That's it. It's just it's an asset test, essentially, is what we are looking at. And then, of course, if you are a couple, you can do that division of assets where ,I covered this at length very recently, so I won't do that today, but you could divide your assets in half in an effort to save the at-home spouse, that community spouse, as much as possible because he or she, they're still living independently in the home. They still have taxes, insurance, monthly utility cost, you all the things. And they need to be able to continue to be able to pay for things and live independently. And if you need to look at a division of assets or consider that, and I'm going to talk about the option of that after the break, but I would recommend contacting an experienced and qualified elder law attorney. They focus in this very specific area of Medicaid work, and they know every single in and out that could absolutely help you in a major way. Coming up next, I'm going to continue the important subject of how to pay for the high cost of senior care.

Speaker 1 20:44

You're listening to Senior Care Live on the Senior Care Broadcasting Network. Have a question? Visit SeniorCareLive.com. Stick around. We'll have more with Steve coming up next.

Speaker 2 22:05

Welcome back. You're listening to Senior Care Live on the Senior Care Broadcasting Network. For podcasts of the program, visit SeniorCareLive.com. All right, so a couple more things on Medicaid, and I'm going to move on. But you have to understand, again, qualifying for Medicaid for the purposes of having the Medicaid program pay the majority of costs on a monthly basis for your stay in a nursing home in a long-term care community. That's the context that I'm talking about this today. It's an asset test, That's all there is to it. Well, Steve, I make way too much money. I don't think I'm going to qualify for that. Well, no, you spend your liquid assets down to $5,909 in the state of Missouri, $2,000 in the state of Kansas, and boom, you are in. Here's if you make too much money, here's the thing. Okay. So let's say the nursing home costs $10,000 a month. Unless your income is more than $10,000 per month, you qualify. And , all of my clients, , none of them are making $10,000 a month. If they if they were making $10,000 a month, they probably don't need Medicaid, right? So it just makes sense. Okay, so the reason that it's important, and this is this is so important. I spoke with some folks here recently, and , and God bless them, they were talking about this couple. This couple had no idea how Medicaid works, and they were fearful that the community spouse, the at-home spouse, would literally run out of money completely, paying for the high cost of the nursing home cost, the care that's provided there. Again, you know, $9,000 to $11,000 a month is an average for a shared room in the Kansas City metro area. And they're just terrified of that. So guess what they did? And this this breaks my heart. They got a divorce. They got a divorce so they could split half of the money, split it up, and at least protect that much for the at-home spouse. The thing is, if you work with an elder law attorney, they can do that division on paper. And you don't have to worry about getting a divorce. I'll tell you what, if I were to pose that to that option to my grandparents, and I talked about it with my grandma, she goes, Well, honey, whatever happens, happens. We're not getting a divorce. We've been married for 70 years. Right? A lot of people would think that. So , anyway, let's move on. I want to just briefly touch on your thinking regarding that Medicaid spend down. Well, Steve, I'm not sure if I can afford to pay an attorney. I mean, you know, those attorneys, they're expensive. Or, you know, Steve, I'm not sure if we can afford to pay for your placement services because, you know, I mean, what if we run out of money? I mean, I don't know. I just I gotta hold on to the money for as long as I can. And that is a natural, normal way to think about this. That's how we're all wired, right? That's how that's normal thinking. But we're dealing with funny math here in government programs and all that, so you have to change your thinking a little bit about that. For the person who has the $50,000 and they're spending it down, you're already out of money. It's already spoken for, it's gone. It's gone. Now I know it's not logical to think like that, but this money is already accounted for, it's already spent, it's already gone. You have to use that fifty thousand dollars for things or services for the person needing, you know, going into the nursing home, something that directly benefits them. I mean, if you give it away, you're going to cause a penalty. you can do some other things that would cause penalties. So obviously, you can pay for their care and you can pay for things that benefit them. So if you can use some of that spend down amount to utilize services that will help you get your legal affairs in order, why wouldn't you do that? Why would you not do that? If you could use some of the spend down to hire experts to help you choose the right fit and find the best place available with the placement service, why wouldn't you do that? You see, the spend down amount will go to the nursing home, obviously paying for care, whether you try to do all of this stuff on your own or not. So why not use it to help you do your very best on behalf of your loved one and have some experts in and have them help you through this difficult process? And again, the couple, and I just I feel so bad, and God bless them, they got a divorce just to save half. They could have paid an elder law attorney to save way more than half. It's the best money you've ever spent. All right, I'm going to shift gears. Let's get back on to the topic of how to pay for the high cost of senior care. I've got a couple others here that I want to get to. So let's talk about long-term care insurance. And every time I sit down with one of my clients with senior care consulting, we always have a conversation, a thorough conversation about different ways to pay for the high cost of senior care. So long-term care insurance is a very specific type of insurance to pay for senior care. So it will pay for in-home care, that hourly care that I mentioned earlier, it will pay for that. It will pay for adult daycare. How about that? It will pay for your stay in an assisted living community, and of course, it will pay for long-term care of that nursing home level. So you have a few different features in this policy that that I'm just going to give out some basic recommendations. There's something called an elimination period. It's a deductible, frankly. Okay, so the most common one that I see is 90 days. What that means is you will pay out of pocket for, let's say, assisted living. Okay. You'll pay out of pocket for the first 90 days. On day 91, this policy will kick in and start paying the daily benefit. Now you could have a zero-day or a 30-day or a 60-day elimination period, and your premium will be a little higher. You could also have a 120, 180-day elimination period. That's more out of pocket for you, and your premium will be a little bit less. You see how that works. I recommend a daily benefit of $300 a day. More if possible, but $300 a day is pretty much going to pay the majority of the cost of your stay in a long-term care community. Maybe that and maybe a little bit of your monthly income, and that should cover it. All right. So that is the daily benefit I would recommend. Now, if you have some investments that you have earmarked for care, and maybe they are producing, $100 a day in dividend income, then maybe you combine that with $200 a day of long-term care insurance to come up with that $300. So that's the number. I recommend a five-year term. And I touched on this earlier, probably went right by most of our listeners. The average length of stay in assisted living is two and a half years. Average length of stay in long-term care is two and a half years. You combine the two, and boom, there's your five-year. That's your five-year term. Longer if possible, but I would recommend a five-year term. If you buy a policy that has a three-year term, guess what? Your premiums are less. If you buy a seven-year term, your premiums are more. You see how this works. This is a must-have, non-negotiable, in my opinion. You need to sign up for that inflation writer. Typically, it's a 5% bump. So what happens is every year, if it pays $300, whatever the daily benefit is, next year it goes up by 5%. The year after that, it goes up by 5%. Year after that, it goes up by 5%. What it's doing is it's keeping up with the rising cost of care. So that 20 years down the road, it's still going to pay for that stay at long-term care community or assisted living or whatever it is. Okay, so that is just non-negotiable. If you don't have that 20 years down the road, this policy is going to pay for about half of what it's going to cost you. So you got to have it, in my opinion. The other one that I am absolutely rock solid on, this must be a state partnership plan. And I definitely don't have time to get into that today. Just tell your agent, Steve Kuker from Senior Care Live and Senior Care Consulting, said that our long-term care insurance policy must be a state partnership plan. Don't let them talk you out of that. You must have this. You will thank me later. All right. So , I'm pretty hardcore about that one, too. So that is the long-term care insurance policy recommendations. And coming up next, what is this weekend? It's Memorial Day weekend, and I always discuss the VA Aid and Attendance Benefit program. You don't want to miss that. Don't go away.

Speaker 1 32:43

You're listening to Senior Care Live on the Senior Care Broadcasting Network. To contact Steve or against on his show, visit SeniorCareLive.com. We'll have more coming up.

Speaker 2 33:02

All right, so every Memorial Day weekend, I always talk about the VA aid and attendance benefit. And I also do it , near or on or near Veterans Day as well in the in the fall. So here we are, Memorial Day weekend. Let's break this down. So the VA aid and attendance benefit, this is a little known benefit, and I'll tell you what, it is so valuable, it's unbelievable. And frankly, , most people that I've ever met, unless they work in the in the business, okay, most folks have never they have no clue about this. They've never heard about it. So that's why I always discuss this and other things with my clients with senior care consulting. I always say, are you a veteran or is your spouse a veteran? Was your spouse a veteran? And that's for a very specific reason. So it's financial assistance to help veterans or the surviving spouse of a veteran. Pay for the high cost of senior care. And you have a few areas of rules and requirements. So you must require help with at least two activities of daily living. There's a service-related requirement and a financial criteria requirement. So let's jump into this. On the service side, you must have served active duty military at least 90 consecutive days. And most people I know can check that box very easily. At least one day during a period of war. And I'm going to talk about the different wartime periods for qualifying for this , benefit here shortly. Not dishonorably discharged. Okay, on the financial requirement, your income must be less than the cost of care to receive the maximum benefit. So what is that? Let's say you have an income of $3,000 a month. I'm just making up a number. And you move to assisted living, that's $8,000 a month. Obviously, your income is less than the cost of care. Pretty easy to check that box. This one's important. This is a 2026 number. Liquid assets. So kind of similar to the Medicaid qualifications, checking savings, money market, mutual fund CDs, 401ks, IRAs, all the liquid assets of $163,699 or less. Well, Steve, I have $180,000. Okay, that's fine. Pay for your care, track your cost, and once you get down to that $163,699, boom, you can check the box. And then there is a three-year look back to make sure that you didn't give a million dollars away last year. Now you want to qualify for this benefit. All right, this is for people who need the benefit. Let's not have any abuse out there. All right. And then on the care side of things, you must require assistance with at least two activities of daily living. And the list, pretty straightforward. If you need help with bathing or dressing or transferring, so moving from point A to point B, that's in the area of mobility. Eating, it could be as simple as cutting up food or you know, some other things around eating and then toileting. Okay, and everyone that I know of living in assisted living or a higher level of care, home plus or of course long-term care, all of them are getting help with at least two of those things. Now, 90 consecutive days, at least one day during a period of war. So most of my clients are from the World War II generation or Korean War. So World War II, December 7th, 1941, all the way through December 31st, 1946. If you miss any of these, give me a call. I'll share it with you. Okay. Korean War, June 27th, 1950, all the way through January the 31st, 1955. Then in the Vietnam War, and I'm starting to have some clients who served in Vietnam. So that is August the 5th, 1964, all the way through May 7th, 1975. Well, Steve, I was never, in the in the battlefield. I didn't carry a weapon. I was in logistics in San Diego. Does not matter if you served active duty in the military at least one day during those periods of war, you qualify. You didn't have to be in the theater of battle, you didn't have to carry a firearm or any of that. Okay. So that's the good news for a lot of people. There is one exception. One exception. If you had boots on the ground, this is in the theater of battle. This is firing a weapon, carrying a weapon. Okay, boots on the ground, February 28th. This is for Vietnam. February 28th, 1961 through 75. Okay, so how that works is for everyone, August the 5th, 1964. But it goes back to February 28th, 1961, if you had boots on the ground. Hopefully that makes sense. So what does it pay? A single veteran, it will pay a maximum, these are 2026 numbers, it'll pay a maximum of $2,424 a month. That could stretch out your your cash flow and help out in a major way. The surviving spouse of a veteran who otherwise would have qualified, it does extend to you a maximum of $1,558 per month. And then a married veteran, a maximum of $2,874. Most of my clients are either single veterans or the surviving spouse of a veteran. Okay, and then who can help you explore the benefit? I always refer everyone to the national headquarters of the VFW. They just happen to be right downtown Kansas City. They are awesome. They will help you free of charge. And I can't say enough good things about our friends there. And then since this is Memorial Day weekend, I just want to I want to brag on my grandpa Cuevas just for a second. He was in World War II. He was in a battle. They were being fired upon. He got hit. He got hit in the knee. And I cannot imagine how painful that was to take a shot in the knee. And his buddy right next to him got shot and he was hurt very badly. My grandpa was still ambulatory, so and this is the greatest generation, right? Picked up his buddy and somehow got both of them out of harm's way and saved that man's life. And my grandpa was awarded the Purple Heart for that act of heroism and bravery. So that's , that's just spectacular. The greatest generation. They don't call them the greatest generation for nothing. I'll tell you that. They earned all of that. And I recall so many times my grandma Kuker, she would say, Oh, it's decoration day this this weekend. And I'm like, Decoration, what is that? Well, that's what a lot of people call Memorial Day, decoration day, because you would go out and pay a respect to all of the fallen and all of who have gone before us and decorate the grave. So , we always put a flag at the at the foot of my grandpa Cuevas's grave, and of course we decorate all the other grave sites and my mom and I we do that every year. It's , one of our traditions, and we love that. So I hope you're enjoying your Memorial Day weekend. All right, I'm Steve Kuker, and I wish you grace and peace. May God bless you and your family on this day and always. Join me next week, right here on Senior Care Live.

Speaker 42:51 Speaker 2 43:51