The Fiscal Physical Retirement Podcast
Smart Retirement Planning. Straightforward Advice.
Welcome to The Fiscal Physical Retirement Podcast, the show built for professionals and pre-retirees who want clarity, confidence, and control over their financial future. Hosted by Aaron Hoisington and retirement planner Ryan Nelson, founder of Alchemy Wealth Management and author of Your Fiscal Physical, this podcast delivers practical advice, expert insights, and real conversations about retirement readiness, tax-efficient investing, and long-term wealth strategies.
Whether you're five years from retirement or just starting to get serious about your financial goals, each episode simplifies complex financial topics into clear, actionable steps. No jargon. No fear. Just the guidance you need from a trusted financial advisor serving Nevada and beyond.
If you’re looking for a retirement podcast that’s approachable, insightful, and worth your time, this is it.
Subscribe now and get your Fiscal Physical. Your retirement health depends on it.
The Fiscal Physical Retirement Podcast
Long-Term Care Explained: What It Costs, Who Needs It, and How to Plan
Use Left/Right to seek, Home/End to jump to start or end. Hold shift to jump forward or backward.
He covers the three main options for handling this: buying long-term care insurance, self-insuring if you have enough wealth, or relying on Medicaid if your assets are limited. The episode explains how to think about which option fits your situation and what questions to ask an insurance professional before making a decision. Because LTC insurance policies vary significantly, consult a licensed insurance professional before purchasing any policy.
Find "Your Fiscal Physical" the book on Amazon
If you have suggestions or feedback, please email us at: Podcast@AlchemyWealth.com
And, as always, Stay the Course!
Planning for Long-Term Care Insurance
Speaker 1Welcome to the Fiscal Physical Podcast . Join us each week as we sit down with the founder of Alchemy Wealth Management and author of your Fiscal Physical , Ryan Nelson . Tune in to gain valuable insights and practical tips as we simplify complex financial concepts into digestible lessons . From budgeting to retirement planning , this podcast is your go-to resource for mastering financial literacy .
Aaron HoisingtonWelcome everybody to this week's episode of the Fiscal Physical Podcast . My name is Aaron . I am joined , as always , by my co-host and founder of Alchemy Wealth Management , ryan Nelson . Ryan , what's happening ? My man Not too much . How are you doing today ? You know , can't complain . I'm still above ground Kids healthy , wife's happy at the time of recording this . So keep that in mind .
Speaker 1But yeah , things are going not too bad . Man Can't complain .
Aaron HoisingtonPerfect . You know it's always a good day when we get to do some podcasting here . So let's go ahead and Well , before we get started there , let's make sure we call out our listeners . Thanks everybody who supported us . You can find us on Spotify , apple Podcasts , pretty much anywhere you get your podcasts . You guys got feedback on the podcast . Email us at podcast at alchemywealthcom .
Aaron HoisingtonNow that I've said the word podcast like seven times , let's jump into it here , ryan . So today's topic we're going to be talking about long-term care , and in this section of your book it's one that people our age we're both in our mid-30s , I would say the idea of long-term care , or to think about as you get later in life , is a little daunting and a lot of people tend not to think about that . Sure , but for myself my parents are getting older I think about . When I read this section in your book , I was like , wow , there is a lot of great stuff specifically here that we can cover . So I'm excited for this episode to dive into long-term care and while it might not be applicable to us right now , it's probably going to be applicable to us in our lives at some point , I would say .
Ryan NelsonSure , yeah , yeah , and it's also one of those things that you need to plan for , right ? So , even though you and I aren't retired as of recording , we still want to retire , and so we need to be planning for that retirement today . And similarly , we don't necessarily need long-term care today , but there's a good chance we might need it in the future , and so we should start planning for it today .
Aaron HoisingtonAwesome . Well , let's go ahead and dive into this here . Have you give some ins and outs of what it is , how to plan for it ? I think that's a big piece of it and what you might need to plan for moving on . So go ahead and take it away .
Ryan NelsonPerfect , yeah , sounds good . So before we dive in , I'd say so . We'll talk a little bit about long-term care . We'll also loop in long-term care insurance and how the insurance can help with some of these long-term care needs . So in light of that , I would say it's always worth talking with an insurance professional , so consulting a licensed professional before you do anything with your insurance and make sure you get their advice . I wouldn't want to construe anything we're about to talk about today as advice , but certainly , hopefully , we can do a little bit of educating here . And then the other thing I would say just in regards to insurance . I'm sure I've said this on a previous podcast . I'm sure I'll say it again , like on future podcasts , right , heck ? Maybe even again later on in this podcast . But I love the saying that insurance is not a good investment and an investment is not a good insurance , right .
Aaron HoisingtonThat's a great line , yeah , so those are two different things .
Ryan NelsonThey're both important . Both insurance and investments are important , but they're two different things , right , and we don't want to get them confused . It's sometimes easy to get them confused and sometimes , I believe , they're even almost intentionally sold to be confusing . Or you'll hear somebody trying to sell insurance as an investment or investments as insurance , and that's just not the case . So , and then the last thing I'll say is every policy is different and unique , so it is important to do due diligence . You know we'll talk , you know , in pretty general terms today , but it's not like anything I'm going to say today is a law that applies to all long-term care insurance policies . It may be true of most , but certainly there's other policies out there that could differ . So definitely do your due diligence , consult that insurance professional I mentioned and make sure you understand what it is you're buying before you buy any sort of insurance product .
Aaron HoisingtonSmart . Yeah , I think that could be applied to a lot of things that not only we talk about , but just in general , there's very few , I guess , experts in certain fields .
Speaker 1And there's a lot like this is .
Aaron HoisingtonWe wouldn't be considered experts in this by any means , but it's just more of a general knowledge , like wetting the whistle as far as what this is and giving food for thought overall . So let's do it , man .
Ryan NelsonLet's dive in . So long-term care , what is it so ? Long-term care refers to the services . Typically , it's going to be basically referring to the services that aren't covered by your normal insurance , right ?
Ryan NelsonSo if you think about being later in life and there may be some , effectively , health needs you have that are not covered by your normal insurance , that would be long-term care , and so a term you'll hear looped into this conversation a lot which I want to define is ADLs , that's , activities of daily living , and so some of those activities of daily living , to give you an example , are things like bathing and showering , personal hygiene , dressing , using the toilet , transferring , so moving around the house , being able to feed yourself . So those are examples of what are considered activities of daily living . So oftentimes , if you're not able to complete some of these activities of daily living , you may need long-term care and your typical insurance may not cover it . That's where something like a long-term care insurance might step in and be able to help subsidize some of the financial needs associated with not being able to perform those activities of daily living .
Aaron HoisingtonDoes that make sense ? Yep , absolutely , it makes total sense . I mean the idea it's hard to wrap my head around about not being able to take care of myself , but at the same time , we've all seen it in movies , we've seen it in , maybe , our daily lives . If you had an elderly person that you've taken care of and honestly , like I mentioned before , time gets away from you quick .
Aaron HoisingtonYeah absolutely care of and honestly , like I mentioned before , time gets away from you quick with these things . Before you know it , you could have an incident as you get older and now you can't bathe yourself , or something like that , so that really paints a good picture there , for sure .
Ryan NelsonYeah , and unfortunately I don't know what the data is on this , but just in my small experience , what I often see is somebody is in what we would perceive to be relatively good health , and then either they get some sort of diagnosis and they go downhill really , really quickly and start not being able to perform these things , or they again are seemingly in pretty good health , getting around the house , okay , and then they have like one fall , break a hip or something , lose muscle mass , and then they're never able to do these things again , or at least there'll be a long period of time where they're not able to do these things . And so , yeah , you can think that I mean you can be what's perceived to be in pretty good health and then in a short amount of time , unfortunately find yourself not being able to perform some of these ADLs activities of daily living . So , yeah , so definitely something we'd want to be preparing for . Adls activities of daily living , so , yeah , so definitely something we'd want to be preparing for . So , again , I think it's easy to recognize , okay , if I'm not able to feed myself , you know . So maybe I'm not able to feed myself , or maybe I'm not able to move myself around the house very well anymore , and getting in the shower and bathing myself is pretty challenging . So , okay , I'm going to need support . Maybe I want to stay at my house . I'm not ready to go into a nursing home or something . I want to stay at my house . But I need support . I can't do this on my own anymore .
Ryan NelsonSo there's companies out there who provide those services . Clearly , those services are not going to be free . You're going to have to pay for those services , and if you budgeted for your retirement , just sort of maintaining your normal lifestyle , this is an expense that you may not have budgeted for right . And it's not always the cheapest expense . And especially as these providers have to start providing more and more services more and more frequently , the expense can obviously creep up and up right . And so these long-term care insurance policies are available for purchase , so you could go purchase a long-term care insurance policy and then help protect you . So now you're maybe budgeted for retirement , for a certain lifestyle .
Ryan NelsonNow , if something happens where you can't perform these ADLs activities of daily living , that's where you could effectively use your life or your long-term care policy and start taking advantage of the financial benefits from that to help subsidize these long-term care needs . So what I would say is , if you do start so , basically to qualify for long-term care insurance , typically you need to not be able to perform some of these activities of daily living or have some cognitive impairment . So something like Alzheimer's or something like that would qualify you and then , depending on the policy , a lot of times they will get , they will reimburse . Well , depending on the policy , they may reimburse you or they just may pay directly , but either way , they would help cover expenses for you to stay in your home , for you to move to a nursing home , for you to move to an assisted living facility or even an adult daycare center , depending on your needs and your preferences . So , yeah , definitely a useful tool .
Ryan NelsonI would say that there's data out there . That's One of the questions I get . A lot is do I need it Right ? Yeah , great question Like does everybody need long-term care insurance ? There's only a small percentage of people who should be buying this , this , and so what I would say is there's lots of different data out here , so I would encourage you to go to Google yourself and try to find your own data that you believe to be accurate , but most of the data out there seems to say that roughly 70% of people who are 65 or older will eventually need long-term care .
Ryan NelsonSo it's not one or 2% .
Speaker 1No , it's a big number .
Ryan NelsonRight . So even if that percentage is off by quite a large amount , it's still . I think a pretty large amount of people will need long-term care at some point in their life and then , on average , people are going to need that long-term care , from what I've seen , is between two to five years . Males would typically need it a little bit less . Females would typically be . Once they start using long-term care , females would continue to use it a little bit longer before passing . So you know you might need . You know 70% of people might end up being able to take advantage of long-term care . You know on average they might use it somewhere in the neighborhood of two to five years and long-term care costs are extraordinarily hard to approximate .
Ryan NelsonIt's so dependent on your state , on so many different things , right ? So it's so so hard to try to approximate what you know , especially if you're younger .
Ryan NelsonSo so hard to try to approximate what you know , especially if you're younger you know what's a nursing home going to cost 25 , 30 , 40 years from now . Extraordinarily hard to approximate that , right , but nonetheless , I mean , I think we could still , we want to still at least have . So , even though that's hard to do , it doesn't mean we want to just ignore the averages and the medians , right ? So currently , some of the numbers I saw for 2021 , again , these numbers are sometimes hard to find like super up to date , but so like home health , so somebody coming into your home kind of helping you out those numbers again median costs in 2021 was around $60,000 . Adult daycare was around $20,000 . Assisted living facilities were around that $60,000 . And nursing home was around $100,000 . Wow , so you could see how you're looking at somewhere between excluding adult daycare . You're looking at somewhere between excluding adult daycare . You're looking at maybe somewhere between $60,000 and $100,000 of costs . Now you're probably going to have some other costs , right ?
Ryan NelsonLike if you go into a nursing home you're probably going to have some of your other entertainment costs down . While this cost goes up , you may be selling your house right . So there's going to be a balancing of costs . So it doesn't mean that if this cost costs $100,000 , that doesn't necessarily mean you need a long-term care policy that will cover $100,000 . There'll probably be some other costs that disappear when you move into a nursing home , but nonetheless it's good to recognize how expensive that can be . It can definitely be a burden , especially if you're paying $100,000 a year . If you're on the high end of that average , maybe you're in there for five years . Heck , there's half a million dollars .
Aaron HoisingtonOh yeah , and definitely with that too , just these .
Considering Long-Term Care Insurance Options
Aaron HoisingtonObviously , you said it's hard to find numbers specifically that are accurate and once again , every place is probably going to cost differently .
Aaron HoisingtonHuge variance between location to location . Yeah , but I think about what you said and it's really making me think about , you know , planning for your retirement . Like you're like , okay , cool . Like if I , you know , want to just use round numbers , like if I want to maintain my lifestyle , I need $100,000 a year , that's what I've been planning for , everything like that . And then it's like well , actually long-term care , I need to go into this nursing home , say , for five years . Now it's like , oh , that costs $100,000 . It's like , well , that's it , that's all my money that I'll potentially save .
Aaron HoisingtonYeah , you have nothing else for the group and if you think about the cost now , if I'm planning for $100,000 in 30 years , 40 years , what's this number going to be ?
Speaker 1then who knows ?
Aaron HoisingtonSo that's , that's , that's a . It's a interesting cost that you don't really think about . I don't know if a lot of people really think about oh yeah , like I , when I get old , I'll just die , Like it's . That's not normally how that works .
Ryan NelsonSpecifically , Sure , yeah , yeah , definitely it's again , if you know , if we trust this data , you know , maybe somewhere in the neighborhood of 70-ish percent of people .
Ryan Nelson65 or older are going to need it . Yeah , it's a large percentage , right ? And then ? So now let's finally maybe answer that question . So who really does need this , right ? So if 70% of people qualify for long-term care , who needs this long-term care insurance ? So to your example maybe you were budgeting $100,000 a year to live on in retirement . Well , yeah , we just saw this could be a half a million dollar additional expense . That's a lot , right , and so should everybody be buying it ? Should nobody be buying it ? What I would tell you is so certainly , buying long-term care insurance is a potential solution , right ? There's two kind of extreme examples I would give where I think maybe you might not want to consider long-term care insurance just yet . So let's use that same example just to keep the theme going , or the thread going . So if you were living on $100,000 a year , right , if you had , let's say , you know , tech CEO style money and you had $5 billion , sure . Yet you're somehow , for some reason , only living on $100,000 a year .
Aaron HoisingtonAll right yeah .
Speaker 1Probably doesn't really matter if you need to .
Ryan NelsonYou don't need to buy some insurance product If you need to go into long-term , if you need to spend another half a million dollars for long-term care at the end of your life , you have plenty of money to do it , drop in the bucket there .
Aaron HoisingtonThat's no big deal .
Ryan NelsonAnd now that's probably a silly example , but it does show one extreme . It's very possible that you've saved enough money where you can what we call self-insure . So you have an extra half a million dollars sitting around . You could put it in an account and earmark it for long-term care and you say this is my long-term care insurance . Effectively , If I need long-term care , I have half a million dollars set aside that I'm going to use for it . Right , and the nice thing is you could then invest out you know $500,000 , let's call it and if you don't end up needing long-term care , it's .
Ryan NelsonIt's no longer just use it or lose it . You can pass it to your kids , you can pass it to your spouse , you can go to your grandkids , Right . So it's that you have yourself covered if you do need it . Right , you have the money there if you do need it . And if you don't end up needing it , you can keep it in the family line and pass it to your kids , and that's a pretty nice little benefit , right ? So that'd be what we call self-insuring . So it is possible to have enough money above and beyond what you believe you'd need just for normal retirement spending , where you could start self-insuring things like long-term care needs right .
Ryan NelsonSo that'd be one example If you have enough money above and beyond what you think you need for retirement .
Ryan NelsonObviously , if you have 50 billion or 1 billion or whatever , that's plenty . You might even have $10 million and you might say , yeah , you might get to a point , depending on your lifestyle , that that could be plenty to self-insure . And , depending on your lifestyle , you might have $3 million and still have enough to self-insure , right ? So that'd be one example If you have , let's say , more money than needed for retirement , you could potentially self-insure .
Ryan NelsonThe flip side of that is let's pretend you think you might want $100,000 for retirement and you're way undersaved so far . So you're putting all your money towards just getting ready for retirement . Buying a long-term care policy is going to make it even harder to prepare just for your normal retirement , right ? So if you don't even have enough money where you're scheduled like you're sort of but I'll put an air quote scheduled or planned to run out of money maybe by 70 , I don't know that you need necessarily a long-term care policy . You don't have enough assets even yet to make it to when you would need long-term care policy . You don't have enough assets even yet to make it to when you would need long-term care right .
Ryan NelsonAnd you could always use something like Medicaid . If you run out of all of your assets , there are federal resources out there like Medicaid that would step in and help provide some of these services . Obviously , that's not a great planning strategy . We don't want to count on you using something like Medicaid and spending all of your money down to zero , but certainly if you're in that bucket of people who have not yet reached your retirement goals , so you're kind of At this point . If you look at your plan , it does show you running out of assets . You might be better off continuing to pile all extra money towards getting your retirement plan dialed in before you put any extra money towards long-term care . So that'd be two examples of people who may not be good fits for long-term care , but then a perfect fit for somebody with long-term care is like maybe you're right on the money .
Ryan NelsonYour retirement plan is right on the money . You're like man , I need $100,000 a year . Like I have just enough nest egg . Maybe just a hair more nest egg to reach my goal , just a hair more nest egg to reach my goal . You might say God , one of these long-term care events would devastate me , it would destroy my plan . Well cool . You could pay long-term care , start building that into the plan and then you're subsidized If something does happen . Maybe your plan it's one of the wrenches that if it gets thrown in , you're okay . Your plan can still be what I'll put in air quotes successful . So that might be an example of somebody who could actually benefit from long-term care insurance .
Aaron HoisingtonAwesome . That's some great three great examples there of potential different ways of looking at long-term care , of if you need it might not need it . This might be a dumb question , but where do you buy these policies ? Is this through it's through an insurance broker ? Are there specific like- ?
Ryan NelsonI'll be honest , aaron that's the dumbest question I've ever heard .
Aaron HoisingtonWell , just wait till later .
Ryan NelsonYeah , so these are typically going to be sold by somebody who sells life insurance . Okay , gotcha , so it all depends , and there's so many different insurance companies out there who do different types of insurance , but more traditionally , what we call your property and casualty agent wouldn't be able to sell you your long-term care insurance You'd probably want to go to your life insurance person and ask them about long-term care .
Ryan NelsonBut , yeah , you're going to want to go find somebody who's doing life insurance type planning to help . Or a financial advisor who's licensed to sell life insurance can also do this , obviously , but it's going to be more like a life insurance salesman or a life insurance company that would provide the services , as opposed to like auto and home insurance .
Aaron HoisingtonI was going to say I can't , probably I don't know if Geico like just I don't know At this point , geico probably does everything .
Ryan NelsonHonestly , I mean , I think a Geico more for home and auto myself . Sure , so they , but I would bet that at this point Geico probably has their hands in everything . Right , they're just so darn big , yeah , bundling everything together . I honestly don't know .
Aaron HoisingtonBut awesome , ryan . Well , that's great man that really answers , kind of just clears up what it is and what it isn't , and who might need it and how to start planning for it . Because it is one of those things that these numbers speak for themselves as far as , like 70% of people give or take are going to need this service in some format . So just kind of start putting it on the radar , even if it's early in your life . Be like okay . Well , if my retirement plan is spot on , like what could potentially derail it ? And one of these events could well maybe . I want to take a little . You know , one of our original episodes talked about lifeboats .
Ryan NelsonLike maybe take out a couple of lifeboats on this specifically .
Aaron HoisingtonYeah , absolutely yeah , great analogy , Awesome . Well , that's all I had here , anything else before we wrap up this specific segment . Nope , that's perfect .
Speaker 1And now to put the personal in personal finance .
Median Age Insights
Aaron HoisingtonWelcome back to this side of the Fiscal Physical Podcast and , as all our listeners probably know , or if you are just tuning in for your first episodes I'm a big trivia guy and I think you are as well , ryan . You enjoy trivia . I would say I don't know if you're a big trivia guy , but you tend to humor me and answer my questions .
Ryan NelsonYeah , I humor you I would say I don't know if you're a big trivia guy , but you tend to humor me and answer my questions . Yeah , I humor you .
Aaron HoisingtonSo , with this episode being long-term care and thinking about age as a factor with a lot of these things , so I got a question for you . So what is , according to worlddatainfo , the current median age in the United States ?
Ryan NelsonThat's an interesting question . So how many median ?
Aaron Hoisingtonyeah , median . So the average overall age of people like the median slightly different than average .
Ryan NelsonSorry , yes median age .
Aaron HoisingtonSo like , um , what's the difference between median and average ? This might once again dumb .
Ryan NelsonI told you yeah , yeah , let's circle back to that , okay um , I would tell you that the average or the median age is probably gosh . It's got to be probably younger than you would think , probably quite a bit younger than you would think . I would say maybe 39 . That's exactly what it is .
Aaron HoisingtonReally it's 38.9 .
Ryan NelsonWell , I didn't know we needed to go to a decimal .
Aaron HoisingtonYeah , yeah you would have thrown that in there . But , wow , that's incredible man . But yeah , that number blew me away . I thought it would be older . Yeah , like , I was thinking like 50 , something like that , just with , like the idea of like baby boomer and these different kind of things . But like , yeah , 38.9 , like is what it ended up being . So , yeah , wow . So now I'm going to follow up question here what country ?
Ryan Nelsonand how old has the oldest median age ? Right now it's probably a small country . I would think it's a small country , but for lack of really being able to get a good educated guess , I would say you said what country and what .
Aaron HoisingtonAnd what the ages .
Ryan NelsonI'd say Japan . I'd say Japan and I'll say somewhere in the neighborhood of like 43 . That's incredible . You got the country right . It is Japan Nice .
Aaron HoisingtonThat's exactly what it is , and it is actually 49.9 . Wow , impressive Almost 50 is the median age there . That's interesting . Yeah , once again didn't give him these answers . That's incredible . You got Japan right off the bat too . But high quality of life or whatever , people aren't dying over there .
Ryan NelsonYeah , they're healthy .
Aaron HoisingtonThey're healthy , for sure .
Ryan NelsonYeah , I can explain the difference between average and median real quick too .
Ryan NelsonI think that'd be useful for some people . So if we were to take a set of three numbers , let's say three numbers , so number one , number two and number six I'm going to try to make these numbers easy so one , two and six . So if you took , let's say , three people ages one , ages two , ages six , and you said what's the average age of these people , You'd say one plus two plus six , so one plus two , or sorry , let's do one , two and seven . So you go , you have one kid is one , one kid is two , one kid is seven . So you go one , two , seven . No , I wanted one , two , six .
Aaron HoisingtonYeah , I was going to say nine makes more sense than I think . So one two six . One two six .
Ryan NelsonSo if you take the average of that right , you'd go one plus two plus six is nine . Nine divided by the three kids , the average age is three . Right Median is you'd actually take the middle number . So with three numbers it would be the middle number . So between one , two , six , the middle number is actually two . So in that data set the average would be three but the median would be two . Okay , cool .
Aaron HoisingtonLearn something new . Usually you would use median .
Ryan Nelsonlike in most financial situations , you'd use median because you wouldn't want . If you're trying to get useful information , averages can be dragged up , like if somebody has , you know , $50 billion or something , they're going to drag the average completely up and give you an unrealistic example . Sure , so using the median kind of tells you what most people actually think is sort of like an average sort of somebody in the middle right . And the average is just subject to get distorted by extreme numbers .
Aaron HoisingtonCool , yeah . No , that was great , ryan , you crushed that trivia and great episode overall . Really appreciate you sharing your insight , as always here . So we'll go ahead and wrap this one up here and appreciate all the listeners . Hit us up with any feedback , any topics you want us to discuss , and I'll turn it over to you , ryan , to play us out .
Ryan NelsonAs always , stay the course .
Speaker 1Thank you for joining us for the Fiscal Physical Podcast . Until next time , happy listening and , as always , stay the course . If you have a question or topic suggestions , please email us at podcast at alchemywealthcom .
Personal Finance Podcast Information and Resources
Speaker 1If you enjoyed today's discussion , subscribe to the podcast to ensure you never miss an episode and consider leaving us a rating and review on your favorite platform . This helps other listeners like you find the show . For more resources , you can visit Alchemy Wealth Management's website at wwwalchemywealthcom or find your fiscal physical the book on Amazon . We'd be remiss if we didn't mention that personal finance is just that personal . Please don't take anything we say as advice . The preceding content is for informational and entertainment purposes only . It's not an offer or a solicitation , nor should it be construed or relied upon for tax , legal or investment advice . It doesn't consider your personal financial situation or objectives and may not be suitable for you .
