The Real Cost of Care: Planning for Long-Term Care and Caregiving with Raymond Lavine

Today, I’m joined by long-term care specialist Raymond Lavine for a conversation about something many of us don’t think about until we’re already in the middle of it: how we’re going to manage and pay for care as we get older.

Raymond and I talk about what long-term care actually means. It isn’t necessarily medical care. It can be help with bathing, dressing, eating, getting to appointments, moving safely through your home, or managing the everyday tasks that allow you to continue living your life.

We also talk about what happens when there hasn’t been a plan in place and family members suddenly become caregivers. Caregiving can have an emotional, physical, and financial impact, especially when everyone is trying to make decisions in the middle of a crisis.

Raymond shares three important questions he believes we should all consider when thinking about our future care: Where do you want to receive care? Who do you want to provide it? And how will you pay for it?

We talk about why those questions are much easier to answer before care is actually needed, as well as some of the assumptions people make about what Medicare, Medicaid, or other programs will cover.

Raymond also explains long-term care insurance, how it differs from disability insurance, what typically qualifies someone to begin receiving benefits, and why waiting until you need care can mean you've waited too long to explore some of your options.

But preparing for long-term care isn't only about buying insurance. It can also mean looking at whether your home will work for you as you age, organizing important documents, sharing passwords and account information with someone you trust, talking with the people who may eventually be involved in your care, and making your wishes known.

Raymond also shares some of his own family's experiences with long-term care and how those experiences have shaped the work he does today.

This conversation is ultimately about giving ourselves and the people we love more choices. We can't predict exactly what our later years will look like, but we can think ahead about what matters to us and make a plan before a crisis makes those decisions for us.

If this episode has you thinking about your own future care, I offer end-of-life care planning sessions to help you think through your wishes, organize the practical pieces, and have these conversations with the people who matter to you. You can visit my website to learn more or schedule a complimentary call.

00:00 Why Plan Ahead

00:22 Meet The Host

01:55 Raymond’s Backstory

03:56 Why Long Term Care

08:07 Insure Yourself First

09:58 What Caregiving Means

11:13 Three Key Questions

17:15 Planning Beyond Insurance

21:02 Government Isn’t Guaranteed

22:39 When To Buy Coverage

27:31 Real Costs And Family Stories

30:06 How Policies Pay Out

33:07 Disability Vs Long Term Care

36:23 Where Raymond Works

38:48 Tools And Life Skills

41:04 Closing And Next Steps

Raymond's web portal:  www.lavineltcins.com

Social Media: 

a. https://www.youtube.com/@RaymondLavine

b. https://www.linkedin.com/in/ltc-benefits

c. https://substack.com/@raymondlavine1

Raymond Lavine

Lavine: LTC Benefits

Telephone or Text message: 253.275.6091

www.lavineltcins.com

Video: https://raymondlavineofficial.com

Transcript

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Raymond: [00:00:00] What motivates me about this is that it's really made me aware of what is caregiving, and what is living, what is dying, that you gotta have a plan. What's interesting to me is that the one thing that people don't think about is insure yourself. You're the best product, and what happens if you don't work properly?

What are you going to do? 

Jill: Welcome back to Seeing Death Clearly. I'm your host, Jill McClennen, a death doula and funeral celebrant. Here on my show, I have conversations that explore death, dying, grief, and life itself, with the hope of making these topics feel a little less intimidating and a little more approachable.

Today, I'm joined by long-term care specialist Raymond Lavine for a conversation about something many of us don't think about until we're already in the middle of it. How are we going to manage and pay for care as we get older? Raymond and I talk about what long-term care actually means, from helping with bathing and dressing, to meals, transportation, appointments, and simply being able to move safely through daily [00:01:00] life.

We also talk about the emotional, physical, and financial impact caregiving can have on families when there hasn't been a plan in place. Raymond shares three important questions he believes we should all think about when it comes to our future care, and we talk about why these conversations are much easier to have before a crisis forces us to have them.

We also get into long-term care insurance, how it differs from disability insurance, when benefits typically begin, and why waiting until you need care is often too late to start planning for it. Thank you for joining us for this conversation. Welcome, Raymond, to the podcast. Thank you for coming on today.

You said you are in Washington State. Is that correct? 

Raymond: Washington State. The state of Washington, not DC. The state of Washington. 

Jill: All the way on the other side of the country from me, where I'm in New Jersey. Thank you so much for joining me today. And why don't you just start me off, tell me a little bit about you.

Are you originally from Washington State? Where do you come from? Anything you wanna share. 

Raymond: Well, I grew up in Hollywood, California, really in the Hollywood [00:02:00] Hills. So Hollywood that on the streets that I grew up, you could see the Hollywood sign. And when I was growing up, my friend George and I would walk up to the Hollywood sign.

And in those days, you could walk there. I think now the Hollywood sign is you need permission to get in, but we just walked up there. We never thought about it. But I grew up in Hollywood and grew up in California, went to schools in California. I had a slight change of plans as I was in the Army for three years.

In the early 2000s, we migrated from California to Washington State, which is where we've lived for over 20 years. Living in Washington is an interesting state, and we enjoy it. I will tell you the thing that we don't enjoy as much is the shorter days of sunlight. People say they like the seasons, and I like the seasons, too.

But sometimes the colder season or the rain is a bit much. But what else? My parents were lawyers and interesting people. I had an interesting [00:03:00] childhood. They were lawyers, but they also liked to travel Really liked to travel. In fact, we took road trips across the country into Canada and did all kinds of things.

Then when my sister and I left home, then they took the more exotic trips. They went to Africa and Asia , you know. And also interesting enough, in California, you know, you have variations of weather, although there were times that the weather could get quite hot. So they didn't have air conditioning when we were living at home, but miraculously, as soon as we left, they got air conditioning.

Don't know what that really meant. I think I asked them once, and I forgot what the answer... So that's something about my background, unless there are other things you'd like to know. 

Jill: Yeah, no, that's perfect. I just like to know a little bit about a person, who they are outside of the work that they do. So it's always nice to just learn a little bit about a person.

So why don't you tell me, so you spend time in the Army. What did you do when you got out of the Army? Like, how did you get to the work that you're doing now? 

Raymond: Well, most of my career has been in financial services, [00:04:00] commercial banking, insurance, mortgage banking. So somewhere along the line it's always been in financial planning.

But for the last decade and a half, I've been solely involved with focused on long-term care benefits. It's been interesting because sometimes I get more out of what I do than what I do to work with people. And there've been a lot of insights because one of the things that I think people don't recognize in us is that we live the same...

They can say, "Well, you're an insurance salesman and you sell a product, and you want me to motivate me to buy something to pay a premium." And that's true, but what I mean by I put as- get as much out of it is that it's not... We live lives, and I have the same issues as everybody else, the things that I need to buy, people that I talk to.

But what motivates me about this is that it's really made me aware of what is caregiving and what is living, what is dying, and that you gotta have a plan. And [00:05:00] you really need to have a plan. And the reason I become more, advocate it more, not just for others, but certainly for myself- That it's important to have a plan, it's important to know what insurance you need and why you need it.

And look, none of us do a lot of things because it's fun. Going on vacation is fun. Buying a car may be fun. Going out and having a nice meal is fun. But there are also practical things that you need to do, and this is where I spend a lot of my time, is not just talking to people, but I spend a lot of time learning.

Mm. Because just focusing on long-term care benefits, you think, "Oh yeah, you could do that, and you could do seven other products." And you can, but you may not do it as well. I mean, think of the pr- you know, the dentist may do certain things, but then it's, depending on what it is, they will send you to a specialist.

Mm. The same with physicians. And there... But my area of, you know, interest and focus is long-term care benefits. I don't want to do property casualty, I don't want to, [00:06:00] uh, employee benefits, I don't want to do home and life, I don't want to do annuities. It's not because they're not worthy of talking to people about, it's just that I just am more interested in this caregiving stuff than I am in, in all the others, and just how much you really need to know.

I'll give you, as an example, i- it's sort of related but hopefully it, it will make sense, is that I have a friend that put in our fence, and he has a son who has severe digestive issues, and he's been to the primary, he's been to specialists, and they just don't know what to do. So now they went to a hospital clinic in California, and that didn't work out, so now they're in Houston.

You know, the point that I'm getting at is that he has a, that specific is- digestive issue, and so he needs to go to specialists. This one actually happens to be in Houston, but you know, you have the Mayo, you have Johns Hopkins, uh, you have Cleveland. So you go to the specialist because that's what they've studied, that's what they know.

In that sense, if you want to [00:07:00] talk about caregiving plans and why and how it will help you, you're better off talking to me than to the generalist. Not because they're not good at what they do. They just may not know as many of the aspects of l- what long-term care benefits may be right for you. Than I do.

And there are others. There are other ver- very good people. I'm not the only one in the United States- Yeah ... that's good at it. But I think I have a, a l- a... I believe that Raymond has a quality level of competence. 

Jill: Hmm. Yeah, that's wonderful. And you're right, we need to talk to the specialist, and long-term care insurance is one of those things that I know exists.

I have a basic understanding of why somebody would get one, you know, what it can cover, but really not that much, which is partially why I have you here, so that I could talk to you. So I guess my first question would be, who should think about having long-term care insurance? Like, I'm 47, is that something I should consider now, or would I wait until [00:08:00] I was older, or if I had a terminal diagnosis?

Like, when's the ideal time to look into having long-term care insurance? 

Raymond: Let me ask it this way. Mm-hmm. When you own a car or a home, that's one of the fir- first things that you look into, is you look for homeowner's insurance or apartment insurance or car insurance. You do it because you know that something may happen.

And what's interesting to me is that the one thing that people don't think about is insure yourself. You know, you're the best product, and what happens if you don't work properly? What are you going to do? Now, most people, if they're self-employed or employed, will have health insurance. That is something they do want, and they know why, because from a very early age, I mean, either they've gotten sick or people have gotten sick.

So it's in the, it's in the DNA or in the knowledge base of people to have certain insurance. They just know that they need to do it. As time goes on, if they have family or whatever it is, they may be concerned about owning life [00:09:00] insurance and owning disability. All good benefits, all things that people should own.

Because if you have a family, if you have responsibilities, if you have debts or if you have financial obligations, people that you owe or... So what happens if you die? Well, then the obligations don't necessarily go away, so what do you do? You fund it. Life insurance funds your life. Of course, that's the interesting thing too is, you know why pe- they don't call it death insurance?

Mm-hmm. I, I think the reason they don't call it death insurance is because the idea is it's life to your family. Which, you know- Yeah ... maybe it's, maybe it's a good marketing term. I mean, yeah, you have to die in order for the benefits, I'll, I'll, I'll- Mm-hmm ... I'll, I'll agree to that. And the same with disability insurance.

That you sh- you need to own that because it will replace a certain proportion of your income if for some reason you're ill or have some situation, cognitive or something, where you can't... If you're employed, it'll replace some of your income. But the other thing that [00:10:00] is important for people to consider, and it really isn't in the long-term, the l- the insurance thinking, is what happens if you need caregiving?

And a lot of people just don't know what caregiving is, and caregiving is You're caring, you're caring and giving and helping somebody that needs a daily activity. Now, if it's your children, people sort of know what it is. You gotta clothe them, you gotta bathe them, you gotta feed them. When you're shopping, you gotta, I mean, you- you're negotiating.

They're great negotiators. So you're gonna have all these, you know, you have all these things that you're care- Now, that's for a, a, a minor, a child of which you have, you know, more... They have less rights and responsibility. But if you're an adult, now the game has changed because now it's caregiving to an adult, somebody that has rights and responsibility, but you're still doing the same, you may have to do the same thing: eating, bathing, dressing.

You have to make [00:11:00] appointments for them. A lot of the things that you do as a parent, a lot of things you're doing as a caregiver. So it, it isn't p- in people's thinking of, what happens if I need care? 

Jill: Mm-hmm. 

Raymond: There are three things that I ask people, is where do you want your care? Do you want it at home?

Most people want care at home. Or, or a care center. The second is who do you want to be responsible for your care? Do you want your children? If they like you, you like them. There are a lot of these emotional issues because when somebody is caring for you, you gotta also learn how to be a caregiver if you haven't been trained in it, and I haven't been trained in it, is how do you be a caregiver?

And it's both ways, is that you gotta be kind to caregivers, and that's a whole podcast in itself of what do you have to do as a caregiver? And the third issue is, you know, what do you want your caregiving to do? And the other is how are you gonna pay for it? It isn't free. People think that caregiving is free.

It isn't. Now you can say, "Well, I'm volunteering." Well, volunteering is fine, but all that really means [00:12:00] is you're not being paid, but you are because you gotta g- y- depending on the situa- if your, if your children, if they have to get on a plane or a car to come and see you, whether you have electric car or a gas-operated car, y- you gotta charge it and you gotta pay for the gas and the transportation, and you're paying for time.

There isn't... You know, time has an expense. So these are the things that, you know, that I advocate, and then hopefully you, pe- people will advocate to themselves is to say, "Gee, I hadn't..." The two things that is one, I haven't thought about it or now I understand what this is about, is that caregiving is a big deal.

You know, I mean, dying's a big deal, too. I mean, it's a real big deal, and if you live long enough, you will know people that will die. You're not happy about it, but you know, it happens. And then, see, other issues that come up is if you didn't plan, you know, then people are in crisis. Whether before you die or after you die, if you don't have a plan, if you're not organized, you have a problem.

And so these are the things [00:13:00] that I advocate is if- The one thing that you really want to ensure and make sure that you have a support system is that you have life insurance, you have disability, and you own a long-term care plan. Now, you know, does that always mean you need to own a long-term care plan? I would advocate yes, and the reason I would advocate it is not because, "Well, Raymond wants to just so he can get a fee."

You know- Yeah ... I do it because it helps the individual, and it helps the family. 'Cause there are two things that I know for certain is that one, and I say that for myself, one, I don't wanna feel invisible, and when you need care or if you have health issues, you're invisible 'cause you think of your neighbors, you think anybody knows that you may have an issue.

And the other thing is that everybody, I don't care what culture, how affluent, how educated, how knowledgeable, is that nobody wants to feel vulnerable. No one. Mm. And when you have a health issue, you have a cognitive issue, you have an accident, and there are things you [00:14:00] can't do, you're gonna feel vulnerable.

And what can help these is if you have people that are helping you to do your daily activities, and you can still have a life. You really can still have a life. Don't believe me? Okay, how about President Roosevelt? Had polio in his 30s, and- Because he had the support system, he could be president. Of course, it was a different situation.

I mean, the governor of Texas is in a wheelchair, Greg Abbott. And so there are more people that have some sort of health issue than you may think. But if you have a support system, you can still have a quality life- Mm-hmm ... if you have people to help you. And I'll give you a personal example. My father, three times in his life, had a major car accident, and then he had, uh, a heart attack, and he also broke his hip and his arm, and he needed caregiving for long periods of time.

Now, in that situation, my mother gave up some of her practice for a long time, and there was an economic [00:15:00] cost to it. But the third time, he had a heart attack, and that was the final stage, took two and a half years. Only the point of this is that it took my mother's personal attention, but they had the f- financial resources.

They traveled, they did things, so long as they had people to help them. So if they did go on a trip or do something, if you have the support system, there are a lot of things that you can do. Now, b- but let's get to simple things. If you need caregiving, whatever it may be, that you can still go out, you can socialize, you can have sex, you can travel, uh, you can be involved in activities.

The thing is, you need people to help you, and that isn't always free. And even if you think the people are volunteering, or your family, it still isn't free. 

Jill: Mm-hmm. 

Raymond: But here's the other thing, too, is that when I went in high school, I took, you know, a lot of courses. In college, I took even more courses, but I never took a course in caregiving.

You know, these are things that people don't know how to do, and they may not necessarily know [00:16:00] how to do it well or have the emotional... You know, you need certain skills. So this is where if you have the resources, long-term care benefits, your own personal resources, family and friends, 'cause just because y- you may own a plan or have a plan doesn't mean that your family isn't involved.

Of course they are. But what you want is you want your family to be your family. You want to interact with them. You don't always want them to be making the sandwiches and changing the sheets and transferring you and going to doctor's appointment. I mean, they'll probably do some of these things, but if it's on a regular basis, people also have their own personal lives.

Jill: Mm-hmm. 

Raymond: And, and also, I mean, there's data on this where whether it's a spouse, a partner, or family, eventually there is an emotional and physical toll. And also, you know, age, if you're, i- if both your spouse and your partner... And I always say spouse and partner, 'cause that, you know, whether you're married, not married, spouse, you know, same gender, whatever you may be, is that- Mm-hmm

you know, the spouse or partner may not necessarily be the healt- they may have health [00:17:00] issues. They may have- Yeah ... cognitive issues. So, so even if you have that kind of relationship Doesn't mean that that person can help you. So what do you do? You either have family or friends, or you hire licensed skilled caregivers to come into your home and help you.

The other thing about planning is that if you wanna live at home, then think about home modifications And, yeah, and you say, "Well, it'll be expensive." Well, if you do it incrementally it might add up, but make sure that your light bulbs are working. Make sure that if you need ramps, make sure you need handlebars, your carpets, you know, your bed, your bath.

Jill: Mm-hmm. 

Raymond: These are things that you can incrementally do. And then there's also the thing of if you have your documents in place, do I... Have your, you know... Know where your health insurance cards are, and let somebody else know where your health insurance cards are. Yeah. Your Social Security card, your Medicare, your health insurance.

Do you have directives, whether it's power of [00:18:00] attorney or if you, you know, on life support, you know, end of life. Of course, you could also have, you know, depending if you have a, a right to die state, you know, do you have- Right ... your documents in place to say, "Look, I have..." whatever the doctors are, to say, "The warning lights are blinking.

The expiration date is there. Do I choose to end my life?" So that you need all these things in place both digitally and manually. Have them in a folder, have it in an easy to find place, and let people know. You know, passwords. Make sure people know about what your passwords are. 'Cause most of us now pay for our credit cards on the internet- Yeah

and things are deducted. So let somebody know where that information is. I can't tell you how many times people have called me, or clients or people who just call me 'cause they found my number, probably to someone, "What do I do?" Yeah. "I don't know where anything is. The house is a mess. I didn't know that they had this issue."

So it's also family awareness of what is happening with a person, because people [00:19:00] sometimes don't want to kn- you know, they don't want to see the reality, you know. So, you know, sometimes they're simple. Open up the refrigerator, you know, if you see a label says 2010 or, uh, you have an odor, maybe something's going on, or the house isn't tidy or the light bul- a lot of the light bulbs are out.

To have people bathe themselves. There are a lot of signs that you just have to know what to look for. I've learned in my times in the long-term care business is that just to be observant. When you go out in public, it's just astonishing how many people are in walkers, they may have breathing canes, or they have mobility so you know somebody's nearby.

You have an idea that somebody has maybe some care issue. And when you go in for your doctor's appointments you're gonna see lots of people that have probably some health issue, and that they need some form of care mo- much more than I think people know or understand. 

Jill: Yeah. A lot of people do need... Even if it's not full-time, like 24-hour [00:20:00] caregiving, they need a significant portion of their day to have care.

And, you know, you're so right where you pointed out that, you know, we think like, "Oh, well, family's just gonna, like, step in and do it, and they'll do it for free." But of the cost of- Like you said, gas, the cost of anything that we need to provide to help, but also loss of work because there's a lot of us that if we are trying to care for parents Or even some people that are trying to care for a spouse that has maybe got a diagnosis when they're younger.

We're still needing to work, and trying to work and also be a caregiver is not impossible, but long term that's not an ideal situation. And I don't think people understand how hard it is to caregiver somebody full time while on top of still living our normal regular life and trying [00:21:00] to take care of the things that we need to take care of.

Raymond: Exactly, and these are things that also people think that social services, Medicaid, or if you have state social service programs. You know, a lot of times people think of it as, "Well, I don't have to plan for it. I pay my taxes, therefore I'll get the social services." There are two things there. One, you might be eligible, but you're not entitled.

For example, I'm a veteran. I may be eligible for veteran's benefits. I may even be eligible for long-term care benefits as a veteran, but I'm not entitled because I have to qualify. And I assure you that there's financial standards, what's the level of care that you need. And the other thing is Americans always say, "I don't want you to...

I don't like people to tell... I don't want government or I don't want somebody to tell me what to do. I don't want... I want to make my own choices." Want to make your own choices? Want to be able to make those decisions? Then have your plan in place. 

Jill: Mm-hmm. 

Raymond: Then so that you don't have to depend on somebody else, you don't have to qualify, you don't have to de- deal with people that you don't [00:22:00] know, that you can hire the people that you want to hire, or you can include the family and you have sufficient resources to pay them.

Then you have self-sufficiency because you have a plan, not be self-sufficiency because you think you're entitled. You're not entitled. You may be eligible, but you're not entitled. In 2026, the reality is that what we think of government or what we think of social services is change. So if we think it'll all work out, well, something will work out, but probably not the way that you want.

And as I said, I think people want to make their own decisions, and the way to make that decision is that you have a plan well in advance. You were asking when should you own or at least talk about caregiving plans, you know- Mm-hmm ... and why. That brings up, there are a number of things. One is financial suitability.

When should you... You know, most people, you know, will think, "I don't have the financial means of social services." Yeah, but the other is that if you have financial resources, [00:23:00] then the question is do you want to... You know, they call it self-funding or I'm gonna self-insure. Well, there's an expense to that because if you don't have a plan, you're gonna have to get the resources from someplace, and it's usually, you know, it's your assets or your cash flow.

And there's nothing in the tax code that says if you need caregiving that you get a grant or a tax deduction for it. So if you have to sell something it's a capital gains. So these are things that people don't think about. And actually something else that came up too, when you think of the c- costs of owning a vehicle, I remember the first vehicle I bought, I think it was $2,500.

You know, it was probably a lot in those days. But now the average car is 35, 40, 50,000 and people that buy these trucks will spend 800, 1200 for financing a truck or leasing a truck. And I say, "You're willing to spend that much money on a vehicle, well, why would you not want to spend," depending what it is, "150, 3...

or if it's [00:24:00] a fam- a, a couple, 350 or 400 to d- Mm-hmm ... to ensure the most important, and to invest, actually, to invest in the most important thing, you. This is why I advocate for it because in the business they'll say peace of mind or pr- preservation of assets. We use sort of these comforting terms. How about let's get to the real thing is you mean to tell me you don't want to invest in yourself?

You're not a good investment, or you don't want to ensure the thing that makes everything else happen? So that's why I'm an advocate of it. What I say to others, I certainly do for myself. But also the other issue is w- what do you want your plan to do? The financial resource. But the other is your health.

Long-term care benefits, depending on the plan, is health assessment, so the earlier you can get the plan, when the premiums are a lot less, gives your plan time to grow because it's usually cost of living benefits to it just like you have in your home own- homeowners insurance where as the home increases, so does your insurance [00:25:00] plan.

I mean, not the- Mm-hmm ... premiums, but the replacement. That's the other thing too, you know, r- replacement of if something, if you need caregiving, you gotta have caregivers. You're replacing your own self- sufficiency to pay for somebody else. But it's your health, and the sooner you have... y- the better your health, if you're not in situations where you need some sort of a procedure or therapy or something, that's the best time.

The reality is a lot of women are getting breast cancer. So anything like that will delay or depending on the situation, will deny. But there are a lot of people now that have early forms of diabetes, heart disease, stroke, cognitive, e- even in younger people, because it, it depends on your lifestyle. So the sooner you get it, the better the health, the better you are to do it, which is another thing that I advocate is that I think the company should also advocate as part of their employee benefits that they offer long-term care benefits to their employees and pay a certain portion of the premiums.

The benefit to that is that [00:26:00] unlike other employee benefits, it's portable. The plan is portable. And let's say you're 25 or 27 or 30 and you own a plan. If you have, let's say a $2,000 plan in your 30s and it's $45, $50 a month, and you hold onto that, and you have a cost of living, do you realize what that plan's gonna be just if you o- just own that in 50 years, what the value of it is?

So you're sort of like owning a Gerber life insurance plan, is that, you know, you have it, you pay it, you keep it, and as your income grows, you're really gonna th- you're really gonna think about it. $50, and when you consider what you're paying for coffee and your cell phone, that's sort of the national icon now.

I know you have a coffee cup in one hand and your cell phone either in your hand or in your ear. Mm-hmm. But w- if you can't, if you can't do without your coffee cup and your phone, trust me, you also need a caregiving plan along with other forms of insurance to replace what is most likely to happen. As you live, there are going to be health issues, there are gonna be [00:27:00] accident issues.

Not necessarily for a long period of time, but maybe long enough that somebody has to spend time to do caregiving. And also, let me just bring up too, if for a long-term care plan, what does long-term care mean? Mm. Well, by definition for the insurance companies, it's 90 days or more, that you need caregiving more than 90 days.

Yeah. Anything less is short-term. And for most people, they can get by, but if it goes on and on, depending what the issues are, not only is it time-consuming, but it becomes more and more expensive. I'll give my mother as an example. She needed care for 18 years. Okay. But it was gradual, where she started off with she broke both her arms within a month, and that started where she then needed care.

But she died at 103 a couple of years ago. So it was a gradual thing of a disability, and then it became physical. It was never cognitive, but always physical. But as time went on, she became more and more frail, needed more and more care 24 hours. My [00:28:00] mother lived in West Los Angeles, and if you do the arithmetic, and this, my mother was very affluent, but she also owned a long-term care plan.

She finally got the plot to o- to own a long-term care plan after my father had his, you know, final illness. They tr- they both applied for long-term care benefits. She got it; he didn't because he had preexisting condition. Mm. But, but, you know, ju- just do the arithmetic of if you f- if you figure in West Los Angeles it's $50, $60 an hour times 7 times 30 times 12, do the arithmetic of how expensive that gets.

Yeah. But, you know, my mother being in the state plan, you know, Theresa, is that, uh, they weren't insurance buyers. I mean, they owned the insurance that they needed, but they certainly weren't into owning a lot of life insurance. Uh, you know the expression, "I don't want to be insurance poor," and they were sort of of that mindset.

But my mother, you know, I asked my mother, I said, "Look, you're affluent enough. You know, why, why, why did you own a long-term care plan?" And she gave me, I think, the best answer I, I ever heard. She says, "Nobody has that much money to pay for their lifestyle [00:29:00] and for caregiving." 

Jill: Hmm. Yeah. You 

Raymond: know? And that is a good description.

And I said this is because, you know, I mean, this is for, for Raymond, this is just personal experience. 

Jill: Mm-hmm. Yeah, 'cause people don't understand the cost of- hiring care either, you know? And I didn't until I started working at a, like a, they did hourly and they also did live-in caregivers 

Raymond: Mm-hmm 

Jill: And the cost is really a lot of money, and it should be.

I mean, I really do believe that these caregivers deserve to be paid that much. It is a lot of work. It is hard work. You wanna trust the people that are coming into your home to care for you. Right So yes, they should be getting paid that much. But I know most people probably can't afford to pay out of pocket for caregivers, and so that's where a lot of us do end up having to do it [00:30:00] ourselves, and then that puts us, again, in that place of, well, now I'm br- I'm not bringing in an income, and so we're really kind of get stuck.

And if you have long-term care insurance, does that pay 100% for bringing in caregivers? Like, what's that part of it look like? Like, how much does it cover for the help? 

Raymond: There are a variety of plans, and what you're b- what you're buying is time. You're buying a pool of money. You're buying a monthly benefit.

You can have $1,000 a month. You can have up to $15,000 a month, depending on the plan. Okay. So it depends what kind of plan. And then, of course, that goes to financial viability. I mean, I don't say to somebody, "A $8,000 plan, and it will cost you this much," if I understand or if I know that they don't have that kind of financial viability.

So what we'll do is we'll say, "What is within your budget? What would be financially viable for you that you can do all the other things? You can eat. You can do all the other things." I don't wanna just have it where you have such a robust plan that it affects [00:31:00] your other financial viability. That's not being irresponsible.

So what I wanna do is to say, you know, "What's the most we can get?" And you know, I mean, there are a lot of unknowns. You know, I don't know. Y- you can look at family history, and you can say, you know, they live a long time. And of course, all of... Everybody will always say, "Oh, nobody's ever been ill." What do you mean nobody's ever been ill?

Or, "They've all been healthy." Well, yeah, everybody's healthy till you're not healthy. People forget. Some of it is the unknown, so I will ask, "What's the longevity in your fam... But even then, it's when did they... when did any of them need caregiving? Now, if somebody says, "They all die young, and they all die fast," I'll say, "Well, it seems like everybody in your family knows the routine."

And usually they'll say, "Oh, no, no, they didn't." Sometimes you ha- it- it's not challenge them, but it's do the empathy of what are you really thinking? But so we... I can design a plan that we know will fit your budget. It will give 50, 60%. That's, that's a lot better than 0%. Yeah. So it may not be 100%. The other thing is [00:32:00] how long do you think you'll need it?

And again, sometimes it'll be on family history, but there are plans that you can get for $95 a month, true freedom plan, home care, and you're buying hours. So if you want more hours, you can buy a plan that it's like getting a Costco plan. You have the different levels or some other subscription plan. You buy what, it's like a bronze, silver, gold.

So you can buy different levels of plans. But you can get short-term care plans if it authorized in your state. You can get a very good plan for one or two years That can be $125, $150 a month. And if you say, "Well, that's too much," well then what expenses or what things do you really like to do that maybe you cut back a little bit?

Maybe you don't need as much coffee. And I know that that's being judgmental or dismissive, but there's some things... Trade something for yourself, and maybe if you don't have it as often, maybe you'll appreciate it more. But the thing is, when you need care, there's a cost. So you don't need 100%, but if [00:33:00] you have 50, 60, 70% and then the other 30% it's either family or friends or your own resources, so be it.

Jill: And I know there's disability insurance and there's long-term care insurance. But sometimes when I'm thinking of the two of them, they almost seem like they would do similar things. What's the biggest difference between having disability insurance and long-term care insurance? 

Raymond: Well, disability, either you own it p- uh, privately or most people have it through their company, it will replace some portion of their income.

Jill: Okay 

Raymond: Not for caregiving, but for income. And of course, there are also rules about that where it's either your occupation or any occupation. So they can say, "Well, you can't, you know, you can't be an administrator, but you can do this." And then they say, "Well, then, we won't let you have the disability because you can do something else," or it might be for a period of time.

Oh, okay. But it's, it replaces a portion of your income. 

Jill: Okay. 

Raymond: Long-term care benefits, [00:34:00] as caregiving, has nothing to do with your income. So you actually, you can have both. You can get your disability, but also if you need caregiving, caregiving plan will pay for the caregiving, so you can use your disability money to pay for your daily expenses, your expenses.

So that you can do both. The other thing is if, let's say, you don't have disability or the disability for whatever reason doesn't, won't pay but you can work at home, then caregiving expenses you can still work. You have a caregiver. Maybe, you know, you can work from your computer. It'll... It doesn't... It's once you, once you're approved for the caregiving plan, it will pay no matter what, what you do.

If you're working, not working, it'll still pay. The difference is this: It's the qualification. This is where a lot of people get annoyed about, saying, "Well, I own a long-term care plan, I have this, you know, why did, why did they deny the claim?" Mm. Well, they're, they're, they're assuming that the company and the plan you have are all reasonable and legitimate.

Here's the standard. The standard is it's not that you have an illness or you have an [00:35:00] accident or even cognitive. It's what has the illness or the disease that cau- how is it affecting your daily activities? If it affecting two out of the six daily activities, then you will probably be approved to get benefits from your long-term care plan.

Mm. But it's what has the disease or illness done to you? So if there's certain things that you can't do, you qualify. Now, it does happen where you don't do it properly, you file the papers, and they'll say, "Well, where's the doctor's certificate?" Well, you gotta have a licensed physician. You have to have... Or a licensed, a gerontologist, somebody that is licensed to say, you know, "We certify that Raymond Lavine has these issues, and by definition then would qualify for a long-term care plan."

Now, there are issues where, you know, even that doesn't work, that you call me and I, I'll refer you to people that, you know, know how to do the paperwork. And it's the same i- if you wanna do Medicaid planning. It's the same as you wanna do Veterans Administration planning, is that you think you can do it [00:36:00] yourself, maybe, but maybe it's worth it to hire somebody to file the claim that knows the issues.

It's the same as if you remodel your house and you know you need a permit. Maybe it might be more efficient to hire somebody that knows how to deal with the city or county than to do it yourself. And I'm an advocate of do it yourself, but also like Clint Eastwoo- Raymond's gotta know his limitations.

Jill: Hmm. Yeah, and we are actually coming up on the end of our time, so this is perfect timing for me to ask this question. Do you work with only people that are in Washington State? Do you have the ability to work with people around the United States? Like, where can you actually work with people? 

Raymond: I have my license in Washington State, but I have non-resident licenses in most western states.

However, if it's people that work in companies that say, "Look, I'd like to talk to Raymond about, you know, benefits for my company, long-term care benefit," I can work in a- I can work in any state. 

Jill: If anybody wants to reach out to you, if they wanna find out more about you or your services, where's the best place?

[00:37:00] I could put links in the show notes so you don't have to spell anything, but, like, where's the best place for people to find you? 

Raymond: Well, the best place is my website, the Levineltcins.com, or they can contact me 253-275-6091. Let me also just add a thing. Mm-hmm. If we were talking about the cost of care, if you go to my website, go to the upper left corner of my website, and you can put in your information.

It'll give you an idea of what you think your life expectancy will be, and also will show you the cost of care. So just put in that. Don't lie about your lifestyle. I mean, i- if there's certain... You know, if you smoke, say... You know, be honest about it. If you smoke every once in a while, you know, I'll let you fudge.

But it'll give you an idea of what you think your life expectancy is. Now, if you go to the lower right of my website, rather than the 47 frequently asked questions that sort of answer your question maybe not, there are three dots at the lower right of my website, and you can put in questions. You can ask and you say, "Wh- who- who is Raymond Lavine?"

Or you can put in, [00:38:00] "What is long-term care insurance?" Or you can put in what everybody wants to know, "How much does it cost?" You know, they always wanna know the premium. It'll give you, you know, an outline. Or say, you know, "Hi, I'm, you know, 56. You know, what would a long-term care plan cost?" So it'll give you the general idea, rather than have to look at the 46 frequently asked questions or look at all the websites that may or may not, you may or may not understand.

You can put a specific question, and it'll give you a pretty good answer. 

Jill: Wonderful. Yeah, I'll put links in the show notes to your website, and then this way people can access those features because, yeah, that is really interesting to be able to go on and just kind of get an idea because really I think most of us don't have any idea what we could expect.

And of course, you know, we never really know, but at least having an idea of what you can expect will help us all be a little bit more prepared. 

Raymond: There are three things that it's unfortunate in our educational system, and this is where you have to do it yourself, is that if I look back and say, "What are the three things that I think people should know?"

Is that [00:39:00] I think people should be knowledgeable about finances. They should know something about investing. The other thing that people should be knowledgeable is about what kind of insurance, what kind of different insurances. And you can take classes at community college, you can look at YouTube, you can...

But know something about insurance. And what it is and what it does and what the writers are. And the other thing that this is actually something that I've recently become more knowledgeable about is negotiating. Learn how to negotiate. Mm-hmm. Not how to manipulate people. That's not negotiating or haggling.

It's learn how to negotiate and have negotiating techniques so that when things come at you, you know what to do. And the most basic example is, in any job, they're all gonna say, "What do you want in salary?" Or, "You wanna negotiate salary?" Mm-hmm. And negotiating is many, many things. I mean, that's just one of them.

But any time somebody's asking you something or needs something, you're in a negotiation. Don't believe me? When your child comes up and says, "Hi, can I have this?" You're in a negotiation, you know? Yeah. So [00:40:00] those are, I think, three fundamental things that, you know, people really, it would help them in their lives.

That doesn't mean that they won't make mistakes . We'll all make mistakes, but at lea- at least you have some idea of how to have the conversation. 

Jill: Mm-hmm. 

Raymond: And to know when somebody's showing you something, what am I looking at and do I know how to evaluate it? Or if I don't, what questions do I need to ask in order to decide is this an investment that I should do?

And I think, you know, you're gonna use insurance some time in your life. You know, understand how it works and not just be mad at the insurance company, say, "Well, they didn't pay," or, "They didn't do this." It's understand the nuances or to say, "I don't know. You know, let me find somebody that will help me, you know, with a- with either what to buy, or if I have a claim, that somebody can help me file the claim."

Jill: Hmm. Wonderful. All words of wisdom. So thank you so much, Raymond. I really appreciate you coming on today and taking your time. 

Raymond: Well, thank you. It's been a joy, Jill, and I had fun. 

Jill: [00:41:00] Good. I'm glad. I love to just talk to people, and so I'm glad you enjoyed it too. If you've been listening to my podcast for a while and you hear me and my guests talk over and over about how important it is to create a plan for the end of life and to have the conversations with your loved ones about what's important to you, and you're thinking, "Okay, maybe it's time.

Maybe I should actually sit down and figure this out instead of just hoping it all works out later," I get it. These conversations can feel overwhelming or scary or just like something you'll deal with another day. But you don't have to do it alone. If you want help creating an end of life care plan for yourself or for someone you love, maybe it's your aging parents, a spouse, whoever it is in your life, you can book a complimentary 30-minute call with me, and we'll just talk.

We'll get clear on what's going on for you and what the next right steps might be. There's no pressure, just support. The link's in the show notes whenever you're ready. And if this episode made you think of someone, a sibling, a friend, or another caregiver, feel free to share it with them. Sometimes these conversations are easier to start when someone else opens the [00:42:00] door first.

Thank you for being here. The fact that you're even willing to listen to this kind of conversation means a lot.