CCRC “Nitty-Gritty” Need to Knows

 

In a post last year, I wrote about a class that I taught for the first time about continuing care retirement communities or CCRCs. I recently taught the class again. Below are some additional things to consider about CCRCs:

CCRC Definition- A CCRC, also known as a life care or life plan community, is a senior living community that provides independent living, assisted living, memory care, and skilled nursing care on one campus as residents’ needs change. There are approximately 2,000 CCRCs in the U.S.

 

Elitist Concerns- CCRCs are expensive! Entrance fees are often $400,000 or more, especially when a “second person fee” is charged for a couple. Industry experts estimate that only about 10% to 20% of older adults have the financial resources to comfortably afford a traditional CCRC.

 

Early Planning- Experts advise moving to a CCRC before you need to. Once you have illnesses, limited mobilities, and special medical needs, it will be difficult to move and you possibly may not be accepted. In addition, many CCRCs have waiting lists that are five to ten years long to get in.

 

Widowhood Scenario- Spouses in a couple should consider what they will need as singles when the first spouse passes away. CCRCs can provide peace of mind as a source of future long-term care instead of relying on children, which adds a burden to their lives (time and money).

 

Downsizing Challenges- Selling a home and moving to a (generally) smaller CCRC unit can be emotionally, mentally, and physically taxing. It generally takes longer than people think, even when everything goes smoothly. People need to allow adequate time for selling and packing their “stuff.”

 

Pre-Move Measurements- There are online programs (and some CCRCs even have downsizing consultants) to help with laying out rooms and positioning possessions. Don’t pay to move things that won’t fit. Also, remember that CCRC residents typically live there for the remainder of their life.

 

Nitty Gritty Questions- Visit with staff and residents of a CCRC and ask questions about things that are not typically found in the slick brochures that CCRCs provide:

 

§   Is the CCRC profit or non-profit? Is there a “parent” company?

§  What is the CCRC’s bond rating? Ask to see their latest financial statements.

§  What facilities, activities, and amenities are provided?

§  Can you move between housing types (e.g., a cottage to an apartment after a spouse passes)?

§  How much of the entrance fee is pre-paid long-term care expenses for a tax deduction?

§  Is there a residents’ council? If so, how active is it?

§  Is there a resident’s handbook (ask to see it before buy-in)

§  If you move to a higher level of care, how is the transfer made, including moving possessions?

§  What is the average job tenure of CCRC employees?

§  What are the CCRC’s policies on parking and pets?

This post provides general personal finance or consumer decision-making information and does not address all the variables that apply to an individual’s unique situation. It does not endorse specific products or services and should not be construed as legal or financial advice. If professional assistance is required, the services of a competent professional should be sought.

Medicare Need to Knows

 

I recently attended a face-to-face class and a webinar about Medicare. Below are ten key take-aways:

Medicare Description- Medicare is a federal government health insurance program primarily for Americans (U.S. citizens and legal permanent residents) age 65+ and certain younger individuals with a qualifying disability (end-stage renal disease and ALS).

 

Medicare Administration- Medicare is administered by the Centers for Medicare & Medicaid Services (CMS), which is an agency within the U.S. Department of Health and Human Services.

 

Medicare vs. Medicaid- Medicare is a national program that is primarily age-based. Medicaid is a federal/state partnership that varies by state and is need-based (i.e., income and asset limits).

 

Medicare Parts A and B- Both parts are collectively known as “Original Medicare.” Part A covers inpatient hospital care and Part B pays for doctors’ services and outpatient care.

 

Medicare Part C- Commonly known as Medicare Advantage, Part C an all-in-one private insurance alternative to government-run Original Medicare. Coverage is coordinated by a private insurance company approved by the federal government rather than by the government itself. Some Part C plans include dental coverage. Open enrollment period every year is a time to shop around.

 

Medicare Coverage Split- According to KFF, 55% of Medicare beneficiaries are enrolled in Part C and the remaining 45% retain Original Medicare. Most people in the latter group buy Medicare supplement insurance (Medigap) to cover Medicare deductibles and coinsurance.

 

Medicare Part D- This is insurance program that helps cover the cost of outpatient prescription drugs. It can be added to Original Medicare or Medigap insurance or it can be part of a Medicare Advantage plan that bundles prescription drug coverage with medical benefits.

 

Medicare and Long-Term Care- Medicare does not cover long-term "custodial" care (help with everyday activities like bathing or eating). However, it does cover up to 100 days of skilled nursing facility care or rehabilitation following a qualifying hospital stay of at least three days.

 

Medicare Losses- Medicare experiences billions of dollars in annual losses due to fraud and abuse. Senior Medicare Patrol (SMP), a federal program, helps Medicare beneficiaries and caregivers prevent, detect, and report Medicare fraud, errors, and abuse. SMP operates in every U.S. state.

 

Medicare Appeals- Beneficiaries can appeal a decision not to cover a specific medical procedure. A common culprit is that the billing code was entered incorrectly. About 70% of appeals are successful. Of course, documentation is needed to present a strong case.

This post provides general personal finance or consumer decision-making information and does not address all the variables that apply to an individual’s unique situation. It does not endorse specific products or services and should not be construed as legal or financial advice. If professional assistance is required, the services of a competent professional should be sought.

Barbservations From a Death Cafe

As I have noted previously, I volunteer as a room host for the same non-profit educational foundation that I am a paid instructor for. As a result, I get to learn a lot of interesting things for free. I recently attended a Death Café class as a volunteer (and observer). Below are my key take-aways:

Death Café Definition- A Death Café is a welcoming, group-directed conversation where people gather to discuss death, dying, and end-of-life experiences in a safe, respectful environment. It is NOT a grief support group or counseling session but, rather, an opportunity to share thoughts, ask questions, and engage in meaningful dialogue. A local hospice agency facilitated the group.

 

Death Café Movement- This program was definitely not unique to the Florida city where I live. The Death Café movement began in Switzerland in 2004 and later expanded internationally, encouraging open conversations about mortality and helping people make the most of their lives. People enjoy free refreshments as they talk about death and dying in a relaxed environment.

 

Range of Emotions- After an initial full group conversation, the16 attendees were divided into two smaller groups of eight. Over the course of 90 minutes, I observed both hearty laughter and heavy sobbing (men and women alike!) as people shared stories about themselves, their loved ones, and their greatest joys and fears. There were no lectures but, instead, totally authentic sharing among people who were strangers. The biggest financial fear that I heard expressed was running out of money during their remaining lifetime, which echoes findings from many older adult surveys.

 

Thought-Provoking Questions- The initial full group conversation started out with three questions: How old do you want to be when you die? How far are you from that age? and What are you planning to do in between? (i.e., what is on your “bucket list?”).  I was amazed that a handful of  people said things like “ I don’t have a bucket list,” “I’ve done everything I want to do,” and I’m OK if it (death) happens tonight.” I erroneously assumed that everyone has some unfinished business on a “to do” list but apparently not so. Instead, I noticed a sense of calm about facing the end of life.

 

More Pointed Questions- In the small groups, people were given large index cards with questions like “Who is your support system?” and “When you die, do you want to be alone or with others?” and “You have one week to live: what concerns do you have?” and “Who was the first person who you saw die and how did you feel?” and “How much end-of life medical treatment do you want?

 

Wide Range of Topics- As a volunteer, I was seated close enough to the two groups to follow their conversations. Among the topics that came up were probating a will, dying without a will, finding an attorney, regrets about not being able to go back to talk with ancestors, several “I wish I’s…”, estranged relationships, fear of an extended need for long-term care, suicide and assisted suicide, and the difficulty of holding end-of-life conversations with loved ones.

 

To summarize, the experience of watching an in-person Death Café in action was enlightening and provided lots of insights to write this post and to prepare future personal finance classes. There are also virtual Death Cafes that are held on Zoom and hosted by various facilitators worldwide.

 

This post provides general personal finance or consumer decision-making information and does not address all the variables that apply to an individual’s unique situation. It does not endorse specific products or services and should not be construed as legal or financial advice. If professional assistance is required, the services of a competent professional should be sought.

 

 

Barbservations From a Tour of Western National Parks

I recently took an eight-day bus tour of national parks out west including the “Mighty 5” in Utah: Arches, Zion, Canyonlands, Capitol Reef, and Bryce Canyon. While Arches National Park was on my bucket list to complete, the entire trip was amazing with all promised services and activities delivered and then some. Below are ten Barbservations:

 

Travel in Later Life- There were several people on the tour in their late 80s who were not able to partake fully in scheduled hikes at the parks. There were definitely past the “go-go” (65-74) and “slow-go” (75-84) retirement years. One older gentleman lost his balance and took a nasty fall, requiring a trip to the ER. I couldn’t help but think that he should have taken the trip a decade earlier. If you are an older traveler with balance issues, bring a walking stick.

 

Career Change Success Story- Our excellent tour guide worked for the National Park Service for 27 years before he was DOGE-ed in 2025. His NPS knowledge and experience added so much to our understanding of the parks and the state of Utah, where he lived. The federal government’s loss (now they want him back!) was our gain. His story is a reminder that people can often transfer well-honed job skills to a new workplace or self-employment (like I did).

 

Amazing Scenery- Rock formations throughout the five national parks and the national monuments (federally protected areas that are generally smaller than national parks) that we visited were breathtaking. An extra special treat was synchronized music with our travel itinerary such as Rocky Mountain High in the Rockies, movie soundtracks when we drove up mountains, and Viva Las Vegas when we pulled into Las Vegas.

 

Benefits of a Travel Agent- I was part of a small group that used a Cruise Planners travel agent and two-thirds of the bus came with a travel agent from AAA. Our travel agent negotiated an excellent value package for us including airfare and airport transfers. Travel agents frequently have access to discounted rates and special promotions.

 

New Technology Tools- During this trip, I used WhatsApp for the first time. WhatsApp is a free instant messaging app owned by Meta. The tour guide invited us to join a messaging group where he shared messages, schedules, and graphic images. He also used another new (to me) tool, PhotoCircle, to share photos taken during the tour.

 

Neutral Topics- We were warned in advance not to discuss “touchy” topics like religion, politics, and current events and, best I could tell, everyone complied, even with the White House cage fight and Washington, DC reflection pool stories being reported at that time. It was refreshing to simply “be present” in the moment, see less national news, and focus on what we were seeing and doing and neutral topics like the weather and where we live.

 

Payment Methods- Several locations did not take cash including a downtown Denver hotel restaurant and several national park concessions. Not sure why. I asked ChatGPT and reasons included reducing the risk of robbery, and employee theft, lower cash-handling costs, and easier accounting. Conversely, some venues charged a 3% fee to use a credit card, presumably to offset the merchant’s fee that they are charged.

 

National Park Status- I did not see any evidence of poor service following the 2025 federal government staff reductions. Park rangers were readily available as guides and to answer questions and gift shops and bathrooms were clean. I did notice long lines for cars to enter the national parks but we breezed in early in a special lane for busses.

 

National Park Stamps- Stamps were available at each of the national parks and monuments and people flocked to stamp their national park passports with a free ink cancellation stamp showing the park’s name and the date of their visit. I learned that there are more than 430 units managed by the National Park Service, including national parks, national monuments, national historic sites, national seashores, national battlefields, and other protected areas.

 

Wildfire Danger- While we were driving throughout Utah, our tour guide pointed out some newly forming fires way off in the distance. Several days after we came home, huge wildfires in southern Utah were on the national news. I sincerely hope that our tour guide, his family and his property are safe as well as others who we met along the way.

This post provides general personal finance or consumer decision-making information and does not address all the variables that apply to an individual’s unique situation. It does not endorse specific products or services and should not be construed as legal or financial advice. If professional assistance is required, the services of a competent professional should be sought.