Longevity & Aging

No doubt about it: at some point we’re neither semi-retired, findependent or fully retired. We’re out there in a retirement community or retirement home, and maybe for a few years near the end of this incarnation, some time to reflect on it all in a nursing home. Our Longevity & Aging category features our own unique blog posts, as well as blog feeds from Mark Venning’s ChangeRangers.com and other experts.

Medical Tourism: a Retiree Health-Care Solution?

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Thailand’s Bumrungrad Hospital, courtesy of RetireEarlyLifestyle.com

 

By Billy and Akaisha Kaderli,

RetireEarlyLifestyle.com

Special to the Financial Independence Hub

From hip replacement, dental procedures to heart surgery, more people are discovering the advantages of traveling abroad for their medical needs.

In just the past few years, medical vacations have gone from a tiny niche market to an impressive growth story with substantial market-share gains.

Hospitals in countries such as Mexico, India, Guatemala, Costa Rica and Thailand are taking advantage of this global trend. And U.S. companies are taking note as well tailoring their corporate health insurance plans to give employees the opportunity to head to India or elsewhere for surgeries such as knee replacements and the more modern, less invasive approach to hip replacement, hip resurfacing.

In the Western Hemisphere, Costa Rica is currently one of the “in” destination for travelers, especially for dental and cosmetic surgery needs. You can schedule online and receive a custom-made package, appointment and prices in your email response.

For years, people in the American Southwest have capitalized on the high-quality dental work available south of the border for a fraction of U.S. prices. Now more people are traveling to Guadalajara in Mexico for body augmentation and other surgeries, too. Many of the doctors there are US-trained, and the equipment is top of the line. (We know, because we’ve used it.)

In Asia, one of the world’s most acclaimed hospitals is located in Bangkok, Thailand. Bumrungrad looks more like a five-star hotel than a medical facility — until you get to the third floor. World leaders from around the globe fly here for medical procedures. Their website is user-friendly, as is its professional, English-speaking staff. The hospital has more than 200 surgeons who are board-certified in the United States. We have quipped many times that the cheapest health care plan is an air ticket to Bangkok.

Also close by is the Bangkok Heart Hospital. Both of these facilities are located in the center of the city, with easy access to shopping and attractions. If necessary, they will arrange your hotel stay along with the medical procedure you’re having performed, all without waiting times or disqualifications. Your entire extensive physical will be done in one morning, with your blood results and consultation that afternoon. In and out in a single day. How’s that for service?

Is it safe?

Many people interested in medical tourism are concerned about the quality and safety of going abroad for technical and complex medical care, and how to get post-operative care once they return home. All of the hospitals mentioned here use the latest equipment and are either internationally accredited facilities or have US- trained physicians on staff. Some U.S. health plans also provide an in-state network of physicians who will treat a patient who’s gone abroad for medical care. The one thing that sets these hospitals apart from many of their U.S. counterparts is their attention to customer service — they are professional and courteous in a way you rarely see any more at home.

For instance, award-winning Fortis Escorts Heart Institute in Delhi and Faridabad, India, manage over 14,500 admissions and 7,200 emergency cases in a year.

India also has top-notch centers for hip and knee replacement, cosmetic surgery, dentistry, bone marrow transplants, and cancer therapy. Virtually all of these clinics are equipped with the latest electronic and medical diagnostic equipment.

Sounds good, but what’s the cost? Continue Reading…

Preparing your Portfolio for Retirement? Income Is so Yesterday

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By Billy and Akaisha Kaderli, RetireEarlyLifestyle.com

Special to the Financial Independence Hub 

When preparing for retirement, designing your portfolio for income is over-rated. Oh, it feels good bragging about how much money you make each year, but then you also quiver about the taxes you owe each April.

What’s the point?

To make it – then give it back – makes no sense.

In today’s interest rate environment people are being forced to adjust their thinking.

Our approach 3 decades ago

When we retired over 32 years ago, having annual income was not on our minds. Knowing we had decades of life-sans-job ahead of us, we wanted to grow our nest egg to outpace inflation and our spending habits as they changed too. Therefore, we invested fully in the S&P 500 Index.

500 solid, well-managed companies

The S&P Index are 500 of the best-managed companies in the United States.

Our financial plan was based on the idea that these solid companies would survive calamities of all sorts and their values would be expressed in higher future stock prices outpacing inflation. After all, these companies are not going to sell their products at losses. Instead they would raise their prices as needed to cover the expenses of both rising resources and wages, thereby producing profits for their shareholders.

How long has Coca-Cola been around? Well over 100 years and the company went public in 1919 when a bottle of Coke cost five cents.

Inflation cannot take credit for all of their stock price growth as they created markets globally and expanded their product line.

This is just one example of the creativity involved in building the American Dream. The people running Coke had a vision and have executed it through the years. Yes, “New Coke” was a flop as well as others, but the point is that they didn’t stop trying to grow because of a setback.

Coca-Cola is just one illustration of thousands of companies adapting to current trends and expanding with a forward vision.

Look at Elon Musk. He has dreams larger than most of us can imagine.

Sell as needed

Another benefit we have in designing our portfolio in this manner, is that when we sell shares for “income,” they are taxed at a more favorable rate as a long-term capital gain. Dividend output is low, our tax liability is minimal, yet our net worth has grown.

We are in control of our income stream.

Our suggestion is not to base your retirement income on income-producing investments but rather to go for growth. You can always sell a few shares to cover your living expenses.

Money Never Sleeps

Just because you retire, your money doesn’t have to.

In the words of Gordon Gecko from the 1987 movie Wall Street, “money never sleeps.” And your money definitely won’t once you leave your job.

Reading financial articles about what if retirees run out of money, we get the impression that the authors do not understand that once retired, your money can – and should – continue to work for you.

Working smart not hard

Once you walk out of the 9-5 for the last time, that doesn’t mean your investments are frozen at that point. The stock market is still functioning and now your “job” is to become your own personal financial manager. Actually, you should have been doing this all along, but if not, start now.

You need to get control of your expenses by tracking your spending daily, as well as annually. This is so easy – only taking minutes a day – and this will open your eyes as to where your money is going. Not only that, but it will give you great confidence to manage your financial future. Every business tracks expenses and you need to do the same. You are the Chief Financial Officer of your retirement.

The day we retired the S&P 500 index closed at 312.49. This equates to a better than 10% annual return including dividends. We know that we have stated this before, but it’s important.

Chart of S&P Market Returns January, 1991 to September 2022

That’s pretty good for sitting on the beach working on my tan.

Making 10% on our portfolio annually while spending less than 4% of our net worth has allowed our finances to grow, while we continue to run around the globe searching for unique and unusual places.

But what if you’re fifty?

You need to take stock of your assets and determine what your net worth is, with and without the equity in your home. Selling the house and downsizing may be a windfall for you, again utilizing the tax code to your benefit. Continue Reading…

10 Tips to help save Money on Healthcare Expenses

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From taking advantage of tax deductions to keeping a healthy sleep schedule, here are the 10 answers to the question, “What are some tips to help save money on personal healthcare expenses?”

  • Take Advantage of Tax Deductions
  • Keep a Healthy Diet
  • Opt For Services In Your Network 
  • Save With Pre-Tax Accounts
  • Ask Questions and Advocate for Yourself
  • Get Robust Health Insurance
  • Compare Quotes to Get the Best Deals
  • Buy Generic Drugs
  • Use Free Screenings
  • Just Sleep It Off

Take Advantage of Tax Deductions

Make sure you are taking advantage of the tax deductions you are eligible for when paying for your healthcare. These include deducting the costs of your health insurance premiums, medical expenses, and dependent care expenses. You can also deduct the costs of travel for medical care and the cost of child care for medical appointments. 

While the healthcare costs are high, you can save money by simply keeping track of the expenses you are already paying and ensuring you itemize your deductions to get the most out of them. –– Matthew Ramirez, CEO, Rephrasely

Keep a Healthy Diet 

Invest in quality nutrition now to save money on health care later. Many people give in to the convenience and comfort of fast food, but it really shouldn’t be a regular part of anyone’s life. Eating whole, colorful foods is the best way to keep your body healthy, and yes: it can be quite expensive to eat healthily.

While organic produce, free-range eggs and meats with no added hormones may bump up your grocery bill, it’s far less expensive than managing a chronic condition like diabetes or cardiovascular disease. My best advice is to take care of your body now so you can save money on health care expenses later. — Jae Pak, MD, Jae Pak MD Medical

Opt for Services in your Network 

Finding strategies to pay for medical expenses without going bankrupt is a daily effort for persons with chronic diseases and long-term treatment demands. Fortunately, the news is not all negative. 

The clever consumer may find big discounts in many typical healthcare circumstances if they know where to search. It is tempting to visit the first care facility with an open appointment when you’re feeling under the weather. However, the costs of various provider alternatives vary. 

Do you need to go to an emergency room? You may see physicians who are in-network or out-of-network depending on your health insurance. Because in-network providers have an agreement with your health plan, you pay less to see them. This translates into reduced prices. — Isaac Robertson, Fitness Trainer & Co-Founder, Total Shape

Save with Pre-Tax Accounts 

Using Health Savings Accounts (HSAs) or Flexible Savings Accounts (FSAs) is a great way to save money on healthcare expenses. You can put money into an HSA or FSA each year and use it to pay for qualified medical expenses, including doctor visits, prescription, and over-the-counter drugs, home medical supplies, and even mental health services. 

These accounts can cover a variety of personal daily products related to first aid, feminine care, family planning, skincare (such as acne treatment and sunscreen), respiratory health, and pain relief. 

The money you put into an HSA or FSA is not taxed, and any money you spend on qualified medical expenses is not taxed either. You can use the money in your HSA or FSA to pay for medical expenses, even if a health plan does not cover you. — Michaela Ramirez, MD, Founder, O My Gulay

Ask Questions and Advocate for Yourself

Sometimes being in a healthcare setting can be overwhelming, especially if you aren’t feeling your best. However, it’s important not to get railroaded into agreeing to things that don’t serve you in the long run. 

For example, a medical professional may suggest a test, treatment, or procedure which you’re uncertain you can afford. Don’t be afraid to ask questions. Why is this necessary? Is there a cheaper alternative? 

Make sure you’re informed about all your options before agreeing to anything. There can be pressure to make snap decisions, but this is your health, nobody else’s. 

“Can I just take a moment to consider this?” is a great phrase to use in order to gain some breathing space. If a medication is recommended, it’s always worth asking whether there is a generic equivalent. These are often cheaper than brand-name products and just as effective. A curious, considered, and calm approach should help you make the best choices. — Alex Mastin, CEO & Founder, Home Grounds

Get Robust Health Insurance

One of the best ways to save money on personal healthcare expenses is to have a robust health insurance plan. Many people think health insurance plans with low premiums are workable. But that’s not true. 

Health insurance plans with low premiums come with other liabilities. They have higher deductibles, and you may get a higher co-pay. Also, low-premium plans don’t cover many things. These plans don’t include particular procedures or tests. 

As a result, your medical expenses can get out of control. Sometimes health plans offer discounts and valuable services. They deliver services that give a boost to your health. You can get all the details from the health insurance company or your health insurance card. — Sean Harris, Managing Editor, FamilyDestinationsGuide

Compare Quotes to get the Best Deals

One great tip that has increased my savings on personal healthcare expenses is to compare the costs of service providers. 

When I was shopping around for a primary care physician, I called various medical offices and asked about their appointment fees. Even though each office listed different pricing, one stood out because it was lower than the other options. 

By taking the time to shop around, I could save money in the long run. Compare-and-save strategies can be used not only with doctors but also with many other areas of healthcare, such as medications and lab tests.  Continue Reading…

Retirement Case Study: Marcus and Lee

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Photo by SHVETS production

by Patricia Campbell, Cascades Financial Solutions

(Sponsor Content)

Ages: 60 & 55

Province: Ontario
Professions: Capital and Facilities Planning Director & Senior Data Analysist

Primary Goal: Determine annual retirement income, save taxes, and plan for travel.

Marcus and Lee were on track for retirement in 5 years, but an early retirement offer from Marcus’ company prompted them to consider retirement earlier than originally planned. We investigate their concerns in this retirement planning case study using Cascades Financial Solutions.

The Issues

Unexpectedly, Marcus was forced into retirement by his company due to a severe downturn in business. The couple thought they had at least five more years before they would need to make a decision regarding retirement.

Over their careers, Marcus and Lee prioritized saving money each year in their Registered Retirement Savings Plan (RRSP) and Tax-Free Savings Account (TFSA). In addition, they both had a joint savings account, and Marcus had a defined benefit pan but, was it enough?

Their Concerns

How much retirement income will they have? Did they have enough money for Marcus to retire early? Lee will continue working until she is 60 but was depending on Marcus to have 5 more years of income and savings. 

How could they minimize the taxes on their retirement? The couple would like to explore tax efficient strategies and are unsure how to approach this.

Will they be able to travel? By retiring early Marcus is concerned about their future travel plans.

The Plan

Marcus and Lee realized that this was a critical time and needed help from someone with extensive experience in retirement income planning.

Marcus and Nicole decided to seek financial planning advice. The financial planner they found uses Cascades Financial Solutions.

The Cascades financial planning process included the below steps:

Gather fact find data. This included the details of each RRSP, TFSAs, defined benefit plan and any joint savings, their investments large purchases they plan on making in the future.

Consider ages for CPP and OAS options. The next step was to run a few retirement income scenarios which included adjusting the start age to receive CPP and OAS.

Choose a winning strategy. After running a few scenarios which included receiving CPP at 60 vs. receiving at 70 they were able to determine a sustainable withdrawal plan and maximize taxes savings over the course of their retirement.

Execute the plan. Finally, it was time to start putting the new retirement income strategy in place. Seeing the plan on paper, gave the couple the confidence and financial security they needed to be at ease.

The Results

Marcus was delighted retiring early knowing their hard work and saving for a rainy day paid off. While Lee wasn’t quite ready to retire, she was happy Marcus can enjoy a few years of retirement before she did. When they are both retired, they plan to take two international trips each year and spend plenty of time with family.

The financial planning process helped Marcus and Lee in several ways: Continue Reading…

Planning for Longevity: How to avoid Retirement Hell

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I never thought that I would fail at retirement and end up in Retirement Hell. But I did.

You see, I spent my entire career – almost forty years- in the banking industry. While there, I learned a lot about money and investing and, over the years, I helped thousands of clients save for their own retirement. Furthermore, my wife is a financial advisor. And yet despite all that knowledge and expertise, I still managed to fail miserably at retirement.

Looking back, I now realize that many of my beliefs about retirement were wrong because they were all linked to the financial aspects of retirement. What I know for sure now is you just don’t fall into a happy retirement because you have a lot of money. You need financial security, of course. But designing a satisfying life takes thought, time and planning on many more levels. You need to know your needs and values, and what makes you happy, and then you have to find ways to satisfy these aspirations on a regular basis. Thinking that you will figure things out when you get there doesn’t work.

Traditional retirement planning has programmed us to think it’s all about the money, but it’s not. In conventional planning, the focus is always on the number: how much money you are going to need to retire. Few financial advisors/planners talk about the other important stuff: how you are going to replace your work identity, how you are going to stay relevant and connected, and how you are going to keep mentally sharp and physically fit, among other things.

Believe it or not most retirements fail for non-financial reasons rather than financial ones. I don’t want that to happen to you so for the past year and a half I along with five of my friends have been working on a new book — Longevity Lifestyle By Design — to help people design a life they would be happy to wake up too.

Retiring from work is simple. Figuring out what you are going to do with the rest of your life is the hard part.

Our mission is to help improve the transition to retirement and help retirees to design a life that they look forward to living everyday.

We know that many people are going to struggle with the non financial challenges that can often accompany retirement. It happened to me, my colleagues and through my discussions with other retirees discovered that it also happened to many of them as well. Continue Reading…