Episode 0002 – Chris Orestis: Planning for Retirement and Long Term Care

In this in-depth conversation, Sebastian Frey speaks with Chris Orestis — widely known as The Retirement Genius — about the urgent challenges facing retirees today, especially around long-term care, Medicaid, Medicare, and financial preparedness. With over 25 years in the insurance and financial services industries, Orestis brings rare insight from both the private market and the public policy side, including experience working in the White House and for the Senate Majority Leader on Capitol Hill.

This episode is an invaluable guide for seniors, adult children, and financial professionals seeking practical, actionable strategies to balance health, financial security, and quality of life in retirement.

Chris Orestis’s Background and Expertise

• Media Presence: Quoted in The New York Times, Wall Street Journal, CNBC, USA Today, AARP, and more.
• Political Career: Began in Washington, D.C., working for the White House transition team, then for Senate Majority Leader George Mitchell of Maine.
• Policy Focus: Specialized in long-term care policy, aging issues, Medicare, Medicaid, HIPAA, Medicare Advantage, and Medicare Part D prescription coverage.
• Industry Leadership: Transitioned to lobbying for the insurance industry and later founded Retirement Genius in 2020 to educate and advise on retirement planning, long-term care, and private-pay strategies.

The Coming Wave of Aging Baby Boomers

By 2030, the youngest baby boomers will turn 65, and the first wave of Gen Xers will begin entering retirement age. This demographic shift is creating unprecedented demand for:

• Long-Term Care — at home, in assisted living, or in skilled nursing facilities.
• Medicare and Medicaid Services — and the funding challenges that come with them.
• Private-Pay Options — for those seeking more choice and higher quality of care.

Orestis warns that while policymakers saw this wave coming decades ago, funding gaps, high costs, and lack of preparation still put millions at risk.

Recent Legislative Changes: How the BBB Affects Seniors

Chris details significant changes from a recent federal “BBB” bill (not Build Back Better, but a large budget measure affecting entitlements):

• Medicaid Cuts: Roughly 10% over 10 years — about $1 trillion — reducing funds available to states.
• Impact on SNAP: Reduced food assistance benefits for seniors and others on fixed incomes.
• ACA Subsidy Reductions: Less support for Affordable Care Act plans, leading to an expected rise in uninsured Americans (potentially 15–20 million).
• State-Level Fallout: Because Medicaid is state-run, reduced federal funding forces states to limit eligibility, cut benefits, or reduce available beds in nursing homes.

Medicaid and Long-Term Care: Understanding the Reality

Key Fact: Medicaid is the primary payer for long-term nursing home care in the U.S.

However:

• Medicaid is the payer of last resort — you must be at or near the poverty level to qualify.
• Once on Medicaid, you lose choice in where you receive care. Expect shared rooms in facilities that operate on tight budgets.
• Private-pay patients get priority access to higher-quality assisted living and private rooms in skilled nursing facilities.

Private-Pay Solutions for Long-Term Care

Chris emphasizes the growing importance of private funding for care. Options include:

1. Long-Term Care Insurance — Best purchased between ages 55–69, before health declines. Can be:
   • Stand-alone LTC insurance.
   • Hybrid life + LTC policies (death benefit converts to care benefit).
   • Employer-provided group LTC plans (often the most affordable).
2. Home Equity — Through reverse mortgages, Home Equity Conversion Mortgages (HECMs), or home equity lines of credit (HELOCs).
3. Life Insurance Conversions — Long-Term Care Life Settlement:
   • Sell an existing policy for a lump sum (often tens to hundreds of thousands of dollars) while alive.
   • Proceeds are used for any type of care: home care, assisted living, or skilled nursing.
   • Eliminates ongoing premium payments and turns an underused asset into immediate funding.
4. Annuities — Can be structured to generate income streams earmarked for care expenses.

Why People Fail to Plan for Long-Term Care

The #1 misconception: “It won’t happen to me.”
Reality: The majority of people will need some form of long-term care during their lifetime.

Without planning:

• Families are thrown into crisis after an accident or illness.
• Confusion reigns over coverage: health insurance and Social Security do not pay for LTC, and Medicare only covers short-term rehab (up to 100 days, partially).
• Loved ones may be forced into lower-quality facilities due to lack of funds.

Crisis Scenarios: What It Really Costs

• Skilled Nursing Facility: $15,000+ per month out-of-pocket.
• Assisted Living: Varies by state, often $4,000–$8,000/month.
• Home Care: Expensive and often uncovered by Medicaid except in rare waiver programs.

Without advance preparation, these costs quickly drain savings, pushing people onto Medicaid.

The Role of Family in Long-Term Care Decisions

Long-term care is a family journey. Even if parents resist planning, adult children are often the ones managing the process.

Chris encourages:

• Open conversations — Avoid secrecy or denial.
• Early documentation — Wills, trusts, medical directives, insurance policies, account statements.
• The “Death File” — A single, well-organized folder containing all vital documents and instructions.

When to Buy Long-Term Care Insurance

• Best Age: 55–69 (before significant health issues).
• After 70: Harder to qualify; premiums much higher.
• Premium Range: Varies by state, coverage features, and health. Expect $5,000–$8,000/year for a mid-60s buyer in good health.
• Payment Options: Annual, monthly, “10-pay” (spread over 10 years), or single-premium lump sum (can be funded from retirement accounts).

If You’re Already Over 70 and Unprepared

Chris suggests a multi-source funding approach:

• Maximize Social Security — Waiting until 70 can nearly double benefits vs. claiming at 62.
• Tap Home Equity — Reverse mortgage or sale.
• Leverage Life Insurance — Life settlement for cash.
• Draw from Savings/Investments — If available.
• Family Support — Shared caregiving and financial help.
• Medicaid — Only if other options are exhausted.

Life Insurance as a Retirement Tool

• Provides a tax-free death benefit to beneficiaries.
• Later in life, can be sold for a lump sum through a life settlement to fund care.
• Final expense policies help cover funeral costs without burdening family.

Action Steps for Families Right Now

1. Inventory Assets — Savings, investments, real estate, insurance policies.
2. Meet as a Family — Include adult children in planning conversations.
3. Work with Licensed Advisors — Insurance agents, financial planners, elder law attorneys.
4. Document Everything — Wills, trusts, medical directives, account info.
5. Explore Private-Pay Options — Before health declines limit eligibility.
6. Plan Early — Waiting until a crisis leaves fewer choices.

Key Takeaways from Chris Orestis

• It’s never too late to start, but earlier planning means more options.
• Don’t rely solely on Medicaid — it’s the safety net, not the gold standard.
• Your home and life insurance are potential care funding tools.
• Talk to your family now — Avoid confusion and rushed decisions in a crisis.
• Work with professionals — Expertise costs you nothing (agents are paid by carriers) and can save you thousands.

Connect with Chris Orestis — The Retirement Genius

• Website: RetirementGenius.com
• Phone: 866-602-5000
• YouTube: Retirement Genius channel — animated explainer videos on retirement and long-term care.

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