Long-Term Care Costs in Florida: Protect Your Wealth

**What's quietly destroying the wealth of Florida's most successful families?** It's not market crashes or economic downturns—it's long-term care costs that can devastate even multi-million dollar portfolios. In this episode, we explore why affluent Floridians can't afford to ignore this hidden risk and how proper financial planning can protect decades of wealth building. Discover why self-funding isn't always the answer, what the latest cost surveys reveal about nursing home expenses in Florida, and how fee-based fiduciary advisors structure comprehensive wealth management strategies that address long-term care vulnerabilities. Whether you have $2 million or $10 million, this conversation reveals critical retirement planning insights that could save your family hundreds of thousands of dollars. Ready to talk? Schedule a complimentary discovery call at TDWealth.net. For educational purposes only. Not investment advice. 📖 Full show notes: https://tdwealth.net/long-term-care-costs-in-florida-protect-your-wealth/

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Davies Wealth Management

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Transcript

SPEAKER_00 0:00

Imagine you spent, you know, the last forty years or so building this magnificent custom designed estate.

SPEAKER_01 0:06

Right, complete with state-of-the-art security, shatterproof windows, a reinforced steel gate, the whole works.

SPEAKER_00 0:11

Exactly. And this estate is your portfolio. We're talking um two million, five million, maybe even ten million dollars.

SPEAKER_01 0:19

So from a traditional wealth management perspective, you've basically done everything right. You're totally insulated against the standard financial shocks.

SPEAKER_00 0:28

But okay, let's unpack this for a second. What if the greatest threat to your estate isn't an intruder coming through that front gate?

SPEAKER_01 0:36

Yeah, what if it's a silent, invisible foundation issue? Trevor Burrus, Jr.

SPEAKER_00 0:38

Right. A crack in the slab that goes unnoticed for a decade, quietly compromising the structural integrity until boom, the entire house collapses inward.

SPEAKER_01 0:47

It's a terrifying thought, but it happens all the time.

SPEAKER_00 0:49

It really does. So on today's deep dive, our mission is to shine a massive floodlight on that exact vulnerability. We are talking about the single greatest uninsured risk to affluent families, which is um long-term care costs.

SPEAKER_01 1:02

It really is the ultimate blind spot because wealthy families will spend, I mean, months agonizing over a half percent difference in investment fees while completely ignoring a health event that could forcibly liquidate half their net worth.

SPEAKER_00 1:16

Yeah, that's exactly why we're digging into this. And to figure out how to actually plug this hole, we are drawing directly from the playbook of Thomas Davies. He's a fee-based fiduciary advisor at Davies Wealth Management down in Stewart, Florida.

SPEAKER_01 1:30

And this analysis is actually tailored specifically for the listeners of the 1715 Treasure Coast Financial Wellness Podcast.

SPEAKER_00 1:37

So as you listen today, I want you to mentally pull out your own retirement blueprint, take a hard look at your safety net, and ask yourself if you know you've been operating under a massive, very expensive illusion.

SPEAKER_01 1:49

Because that illusion usually sounds something like, uh, I have plenty of money. If I get sick, I'll just write a check and self-fund my care.

SPEAKER_00 1:54

Let me push back on that for a second, though. Because on the surface, that assumption makes mathematical sense, right? If I have five million dollars in liquid assets, why would I bother jumping through hoops or buying insurance?

SPEAKER_01 2:07

I hear that all the time.

SPEAKER_00 2:08

Right. Like if a health crisis hits, I just sell off some of my portfolio, pay the facility, and move on. A massive bill is just a drop in the bucket.

SPEAKER_01 2:15

Well, it might be a drop in the bucket if you were paying with, you know, untaxed monopoly money. But that brings us to the core mechanism of the high net worth trap.

SPEAKER_00 2:24

Okay, lay it out for us.

SPEAKER_01 2:25

The question isn't whether you have the raw capital to technically afford it. The real question is whether liquidating your specific tax-deferred assets to pay retail price for care is a strategic use of your hard-earned wealth.

SPEAKER_00 2:40

Right, because it's going to trigger a catastrophic chain reaction with the IRS. Let's ground this in the reality of 2026 Florida.

SPEAKER_01 2:47

Good idea. Florida is a magnet for retirees, which obviously creates an astronomical demand for care.

SPEAKER_00 2:52

Yeah. And based on the 2026 Genworth data, if you need a private room in a Florida nursing home, the median cost is just over$122,000 a year.

SPEAKER_01 3:03

It's wild. Even just bringing a home health aid in for um like 44 hours a week is nearly 64 grand.

SPEAKER_00 3:10

So to pay that$122,000 bill, I have to pull cash from my portfolio. And most affluent retirees hold the bulk of their wealth in traditional IRAs or$401Ks.

SPEAKER_01 3:21

And that is exactly where the trap snaps shut. Pulling$150,000 out of a traditional IRA to pay for a year of nursing care, it isn't just a simple withdrawal.

SPEAKER_00 3:31

The IRS treats every single dollar of that as fully taxable ordinary income.

SPEAKER_01 3:36

Yes. What's fascinating here is the cascading effect. It's like trying to bail water out of a sinking boat, but every bucket of water you throw overboard to pay the facility, the government forces you to take two buckets back on board in taxes.

SPEAKER_00 3:50

That's a brutal analogy. Treating your retirement account like an endless ATM while ignoring the transaction fees.

SPEAKER_01 3:56

The industry actually calls it the tax torpedo. Let's say you're a single filer in 2026. If your baseline income, plus this massive new withdrawal, pushes your total income over roughly$243,000.

SPEAKER_00 4:09

Which it easily would.

SPEAKER_01 4:10

Easily. You are suddenly vaulted into the 32% or 35% tax bracket. So to clear enough cash to actually pay the nursing home, you might have to liquidate over 200 grand from your IRA just to satisfy the IRS.

SPEAKER_00 4:24

Wow. But wait, the torpedo doesn't stop at income tax, does it? That artificial income spike triggers a secondary explosion. Trevor Burrus, Jr.

SPEAKER_01 4:31

Right. The IRMAA surcharges. Trevor Burrus, Jr.

SPEAKER_00 4:34

The income-related monthly adjustment amount.

SPEAKER_01 4:36

Exactly. Medicare looks at your tax return, sees this massive income spike, and decides you're now a high earner, so they slap a surcharge on your Medicare Part B and Part D premiums.

SPEAKER_00 4:46

Which for affluent families can easily add over$500 a month to your health care costs.

SPEAKER_01 4:50

Yep. Plus, that higher income makes more of your Social Security benefits taxable. It's just a cascading wealth destruction event.

SPEAKER_00 4:57

Aaron Powell Okay, so clearly traditional cell funding triggers this massive tax penalty. So the paradigm has to shift. How do we pay the bill without waking up the IRS?

SPEAKER_01 5:05

Aaron Powell You have to shift from a reactive stance to intentionally deploying capital ahead of time so it does the heavy lifting for you. And the first strategy for this is hybrid life and long-term care insurance.

SPEAKER_00 5:15

Now, whenever I hear the word insurance, I immediately think of those old standalone policies our parents bought. You know, you pay a premium every year, the rates keep hiking, and if you die in your sleep, the money is just gone.

SPEAKER_01 5:28

And that is exactly why the standalone market is essentially dead. High net worth families refuse to pay for something they might never use.

SPEAKER_00 5:36

Aaron Ross Powell So how were hybrid policies different under the hood?

SPEAKER_01 5:39

They completely re-engineered the mechanics. Instead of paying an annual premium forever, you drop a single lump sum premium, usually between$100,000 and$500,000.

SPEAKER_00 5:50

Aaron Powell Okay, so a big upfront commitment.

SPEAKER_01 5:52

Aaron Powell Right. But that one-time deposit buys you a leveraged tax-free benefit pool of two to three times that amount. So if you need care, it pays out 10 to 20 grand a month, completely tax-free.

SPEAKER_00 6:04

And what if I never need care?

SPEAKER_01 6:05

If you die without needing it, your heirs get a tax-free death benefit. So there are no wasted premiums.

SPEAKER_00 6:11

I mean, I see the leverage there, but honestly, tying up a couple hundred grand in a lump summit feels like a massive opportunity cost. Isn't that money better off left alone in the SP 500? Just compounding?

SPEAKER_01 6:22

It's a very fair question, but you have to factor in sequence of returns risks.

SPEAKER_00 6:26

Right, the timing of a market crash.

SPEAKER_01 6:28

Exactly. If you leave that money in the S P 500 and the market drops 25% the exact same year you get an Alzheimer's diagnosis, your capital is crushed right when you need it most. The hybrid policy guarantees that pool regardless of market conditions.

SPEAKER_00 6:44

Okay, but let's say I'm stubborn. I have a massive portfolio, say, over$5 million, and I absolutely refuse to buy an insurance product. If I insist on truly self-insuring, how do I do it without walking into that tax torpedo?

SPEAKER_01 6:59

You can self-insure, but it requires extreme discipline. You can't just look at a consolidated brokerage statement, see$5 million, and call yourself self-insured.

SPEAKER_00 7:07

Because it's too tangled up in growth assets.

SPEAKER_01 7:09

Yes. You have to carve out a dedicated care reserve, typically$500,000 to$1.5 million per spouse and physically move it into a different bucket.

SPEAKER_00 7:17

You literally wall it off. Yeah. And I'm guessing it has to be in super safe conservative assets.

SPEAKER_01 7:22

Exactly. Short duration bonds, treasury securities, things that hold their principal value during a crash. So when the medical bills arrive, you drain this conservative bucket first, which prevents you from being forced to sell your growth stocks at a loss.

SPEAKER_00 7:36

That makes total sense. Now what about strategy number three? Because Thomas Davies talks a lot about asset-based planning and optimizing lazy money.

SPEAKER_01 7:45

Oh, this is a great one. We all have dead weight on our balance sheets. It might be a low-yielding bank CD or very commonly an old whole life insurance policy you bought 30 years ago.

SPEAKER_00 7:55

Right, something that has cash value, but you don't really need the death benefit anymore.

SPEAKER_01 7:59

Yep. So you can use a mechanism called a 1035 exchange. The tax code allows you to take the cash value from that old underperforming policy and transfer it directly into a new annuity contract that has a long-term care writer attached to it.

SPEAKER_00 8:13

And because it's a 1035 exchange, you do that without paying taxes on the historical gains, right?

SPEAKER_01 8:18

Exactly. And once inside that new annuity, the long-term care writer acts as a multiplier. It doubles or triples your care coverage. And if it's unused, it still passes to your beneficiaries.

SPEAKER_00 8:29

Wow. So you're basically turning sleepy money into a highly leveraged health care defense fund.

SPEAKER_01 8:35

Precisely.

SPEAKER_00 8:36

Okay, so deploying capital covers the bills. But what about legally shielding the rest of the estate from the government? Because eventually, even a wealthy family could burn through their liquid assets if a care event lasts a decade.

SPEAKER_01 8:48

Aaron Powell And at that point, you're dealing with Medicaid. Now, the state of Florida has incredibly strict rules to ensure people don't just game the system to qualify for state aid.

SPEAKER_00 8:58

You mean the dreaded five-year look back period? I can't just transfer my remaining three million to my daughter tomorrow so I look poor on paper.

SPEAKER_01 9:05

No, you absolutely cannot. Florida will audit every single financial transaction you made over the prior 60 months.

SPEAKER_00 9:12

That's brutal.

SPEAKER_01 9:13

It is. So to legally shield your state, you have to move assets into an irrevocable trust well before you ever need care, like at least 60 months prior.

SPEAKER_00 9:22

And relinquishing control of my money into an irrevocable trust sounds terrifying. But Davies points out that right now, these trusts serve a massive dual purpose.

SPEAKER_01 9:32

Yes, because of the incoming 2026 tax sunset. The federal estate tax exemption is currently historically high, around$13.99 million per person. But it's scheduled to sunset down to roughly$7 million per person.

SPEAKER_00 9:46

So for ultra-high net worth families, these irrevocable trusts provide Medicaid protection and massive estate tax reduction.

SPEAKER_01 9:53

Exactly. They do double duty.

SPEAKER_00 9:54

Okay, here is where it gets really interesting, though. Strategy five. Because I was looking at the notes, and well, what if we strategically shift our money to a Roth IRA before we even get sick?

SPEAKER_01 10:05

Oh man, it's one of the most elegant, underutilized pieces of financial jujitsu out there. Strategic Roth conversions.

SPEAKER_00 10:12

Right. Because Roth withdrawals are completely tax-free. So if I pull$150,000 from a Roth to pay for a memory care facility, it doesn't show up as taxable income.

SPEAKER_01 10:21

Nope. It doesn't push you into a higher tax bracket, and it entirely sidesteps those dreaded IRMAA Medicare surcharges, you completely neutralize the tax torpedo.

SPEAKER_00 10:30

But the catch is the timing, right? You have to execute this during a specific window.

SPEAKER_01 10:35

Right, the golden window. Typically between retirement when your earned income drops and age 72 to 75, which is when the government forces you to start taking required minimum distributions or RMDs from your traditional IRA.

SPEAKER_00 10:48

Because RMDs force your taxable income back up. So you systematically build this tax-free reservoir of capital during that gap year period.

SPEAKER_01 10:56

Exactly.

SPEAKER_00 10:57

This raises an important question, though. Strategy six. What happens to the healthy spouse who is left at home while their partner is in a facility? Doesn't the state just take half of everything?

SPEAKER_01 11:07

This is a brutal reality called spousal impoverishment. In 2026, Florida's Community Spouse Resource Allowance, the C SRA, caps the protected liquid assets for the healthy spouse at a mere$154,140.

SPEAKER_00 11:22

Wait, really, let that sink in. You could be living in a paid-off$1.5 million home, and the state says you can only keep about$154,000 in liquid assets to sustain your multimillion dollar lifestyle.

SPEAKER_01 11:34

It's a fast track to financial ruin for the healthy spouse, which is why high net worth families must utilize proper titling and spousal lifetime access trusts, or slats.

SPEAKER_00 11:45

So the sesslide bypasses that limit.

SPEAKER_01 11:48

Yeah. One spouse places assets into an irrevocable trust for the benefit of the other. Because it's irrevocable, Medicaid can't count the principal. But an independent trustee can still make distributions to the healthy spouse for their lifestyle.

SPEAKER_00 12:01

So it legally ring fences their dignity and security. I love that. Now we've talked a lot about the legal mechanisms, but we have to acknowledge the terrain. Strategy seven, the Florida factor.

SPEAKER_01 12:12

Right, the no state income tax edge.

SPEAKER_00 12:14

Exactly. Pulling 150 grand from an IRA in New York or California means an extra 15 to 20 grand just in state taxes. Florida residents avoid that entirely, which effectively reduces the care burden by what, 10 to 13 percent?

SPEAKER_01 12:27

Yeah. But you have to establish true domicile. You can't just be a snowbird, voter registration, declaration of domicile, it's strictly required.

SPEAKER_00 12:34

And we have to factor in the hidden multipliers that make these baseline costs accelerate so terrifyingly. Like inflation.

SPEAKER_01 12:40

Oh, healthcare inflation does not behave like normal inflation. It runs at four to five percent annually. So that$122,000 room today, it will cost over$200,000 by 2040.

SPEAKER_00 12:51

Wow. And the second multiplier is cognitive decline. Alzheimer's of memory care totally changed the equation, right?

SPEAKER_01 12:58

Absolutely. Specialized memory care adds thirty to fifty percent to the bill, reaching eighty to a hundred grand extra for specialized care. And it lasts an average of four to eight years.

SPEAKER_00 13:08

Which naturally brings us to the free care fallacy. Families see these numbers and think, I'll just take care of my spouse at home. It's free.

SPEAKER_01 13:15

But it's never free. It costs lost income, and it severely compromises the family's health and the patient's quality of care.

SPEAKER_00 13:21

It destroys the caregiver. So knowing all these strategies, the slats, the Roth conversions, it's useless if you miss the window to execute them.

SPEAKER_01 13:29

Exactly. The golden window is between ages 50 and 65. Insurance requires good health for underwriting, Roth conversions require that window before RMDs, and remote trusts need that five-year runway. Starting at 70 is cutting it close. 80 is too late.

SPEAKER_00 13:45

So why should you care? Because there was a 70% probability of needing care after age 65. So taking Davy's wealth management's two-minute financial wellness quiz or booking a fiduciary audit with them is the difference between a reactive crisis and proactive wealth preservation.

SPEAKER_01 14:02

Absolutely.

SPEAKER_00 14:02

I'll leave you with this final thought to mull over. We spend our whole lives trying to ensure our wealth outlives us to create a legacy. But if an unplanned, decade long care event can rewrite your entire family tree's financial future in an instant, perhaps true legacy planning isn't about what you leave behind in a will. Perhaps it's about becoming the generation that financially insulates the family from the vulnerabilities of the human body. Think about that as you review your own blueprint.