Help at Home May Be Hidden Cost from Retirement Drawdown

Some retirement plans are based on the theory that drawdown should be at 4% a year and that there “might be” some higher medical costs near the end of a person’s life span. This is a very flawed way to look at retirement! If you, the advisor are telling your clients that they can expect level spending throughout retirement years and that they can only anticipate a “maybe” for increased medical costs toward the end of their years, you are not giving them reality.

The truth is that many people suffer gradual declines in their independence over time, throughout retirement. This is particularly the case for those who have never embraced a particularly healthy lifestyle. What happens to them? They have to start paying out of pocket for things that are not considered “medical costs”; i.e., those things most folks require to stay at home, rather than go into an institution. This can start with a home care worker. If a person reaches age 80, for example, and has arthritis, which is the number one cause of disability in the U.S., she may need help with bathing, dressing and walking, among other things. Medicare does not pay for the kind of helper she will need to remain in own home. The national median hourly rate is $20, according to the Genworth Cost of Care Survey . Are you planning for this cost with your clients?

The 80-year-old with arthritis may need a knee replacement or hip replacement. Following either surgery, there is an expected period of disability during which a person will likely need a lot of help. Medicare pays for some rehabilitation but that benefit will most probably be limited to a few weeks, at most, while the recovery period at home may be much longer. Again there is an out of pocket cost for help at home that is not covered by Medicare.

This is just one example of a disabling condition that will require increased spending in retirement for your clients. Many aging people have multiple medical conditions at the same time, thereby increasing the likelihood that they will need to draw out more money in retirement than what many advisors calculate as level spending over those retirement years. I hope you can see the flaws in this kind of planning.

Related: The Top 3 Errors Aging Clients Make with Their Finances

You can do better! When you do retirement planning, be sure to help clients understand what they probably don’t want to face: most people will need some kind of paid help as they reach age 80 and beyond. Some will need to pay for help much sooner than age 80. This help is not about level drawdown. It is about increased out of pocket costs that are not considered “medical costs” by Medicare. Medicare supplements do not cover these costs either.

If you are thinking that it’s not a problem because their “fun” spending will slow down as they become more disabled, think again. Travel is not precluded for disabled people. Nor are luxury goods, expensive cars, or other things people like to have as a part of their lifestyle in retirement. Helping your clients understand the need for restraining spending and planning for out of pocket non-medical costs of care is a much-needed service you can provide.