It's Mr. Stilman's Opus. John Stilman joined by a couple of special guests today. Matt Ayotte and Alan Milliken are the founders of Aegis Home Care. They're here to talk about what they do at Aegis Home Care. We're going to talk today about four misconceptions of aging and healthcare.
Guys, first give us the elevator pitch. What does Aegis Home Care do? Who do you serve?
And what's that look like? Thanks, John. This is Alan and we are a home care agency and we provide assistance where people live. So if they live at home, we're helping them get through their day with meal preparation and medication reminders and assistance with bathing and ambulation. We serve the local area, the local triangle area, Orange, Durham, Chatham Counties, and we have approximately 150 caregivers, a combination of certified nursing assistants and companions and nine or 10 nurses that supervise that care. We also have an office in Pinehurst that's built basically the same way.
So we serve Lee and Moore County in the Sandhill region. We're talking about the four misconceptions of this space, aging and healthcare, and the first one is that Medicare will cover this. It seems like we paid into Medicare for 40 years and we're continuing to pay $120 a month for our Medicare Part B, so you're going to step in and cover this, right?
That is a phone call that we get more often than we would like and we have to kind of help folks step back a little bit. Medicare is confusing anyway, you know, Part A, Part B, and now Part C, these Medicare Advantage plans or the MAPD, including the prescription drug plan. The presumption is that, you know, I've got Medicare, I've got Part A and Part B. I also have a Medigap, you know, a Med Supp policy. I'm looking at some of these MAPD programs, these Medicare Advantage, Part D programs.
Somebody's got to cover this. It's in there somewhere, I'm sure. And the unfortunate truth is it's not. So there are allowances for personal care assistance in the home through a home care agency for Medicaid. That's a much longer discussion, but there are some, there is an ability for Medicaid to cover assistance in the home, but not Medicare. It's a harsh reminder, you know, that sometimes those benefits, they are so tricky that it seems to get lost in the shuffle. They presume when they see home health and home health care covered that that's what we're talking about and it's not.
It's a different thing altogether. And I think a lot of people too are just blown away by the difference in nursing home care and skilled nursing. You know, if you go into the hospital, let's say you have a stroke, you end up in a skilled nursing facility where you're getting speech therapy every single day. Well, Medicare does cover skilled nursing. But if you have just one day that you don't have, it has to be consecutive days where you're getting that skilled nursing care. You have just one day where you're not getting your speech therapy that day.
You're cooked. You're no longer covered by Medicare because it has to be every single day for them to step in. And you have to progress.
You can't stay stable. You have to continue to improve in order to continue to qualify for Medicare. So even if you are getting physical therapy or speech therapy every single day, if you've reached a plateau, Medicare will promptly step out and then it will be your responsibility.
All the more reason you have to have a plan in place as part of your retirement plan for how are you going to cover these expenses if you encounter them down the road. We're talking about the four misconceptions of aging and healthcare. Not the four, but four misconceptions.
There are probably more than four, I'm quite sure. But misconception number two is that all CCRCs are created equal. And before you explain why that's a misconception, you should probably explain what is a CCRC. So a CCRC, the acronym means continuing care retirement community. And in general, that means you can move there as an independent person and you can age in place on that campus, meaning that if you get a little bit sicker, you can move into assisted living. If you have more care needs, you can move into the skilled part of that CCRC or they almost always have a memory care unit that you can also have access to. So you start out as an independent person living in a villa and you can progress through the rest of your life in that community.
So that's a thumbnail sketch of a CCRC. And when we say the misconception is that they're all created equal, the way that the care looks at a lot of the places might be pretty similar. But the financial structure of how you get into those places, there's just all these completely different models that I think confuse a lot of people.
And none of them are right or wrong, they're just different. And there are equity models, there are monthly fees, there are differing equity models where you get your money back after you leave there or you pass away. So when you say equity models, break that down.
What's that look like? So if it's an equity model, CCRC, it's almost like buying a home inside that community. So if you bought an apartment for $150,000 or a house for $500,000, you could grow equity in that piece of property.
Typically, they do go up in value over time. But there's also a little bit of a fee structure at the end. If that property has to be turned over to the next person, then there's a charge for that. So sometimes your equity is eaten into a little bit, but you don't lose it. If you pay that money up front, you don't lose it.
It continues to stay part of your property. But you're also buying an insurance product, which is a CCRC. So that's sometimes why it's so expensive, because they plan to take care of you for the rest of your life. So part of that entry fee is put into a fund that helps cover people who run out of money.
So it is an insurance product defined by the Department of Insurance, a CCRC is. At the other end of the spectrum, you may not own anything. You may just pay a really high monthly rent, right? But then you're taken care of down the road, I guess essentially part of your whatever the number is. $6,000 a month rent is essentially buying long-term care insurance for all intents and purposes.
That's exactly right. And of course, in this area, we have a little bit of everything. We've got equity model CCRCs in Orange and Durham County.
We have more of the traditional, almost lease models sometimes that might be more expensive per month. You don't, as Alan said, own anything. You're not building equity. You're not actually buying in in the same way. But the interesting thing Alan led with to me was, it's not a right or wrong. It's what's right for you and what's right for your budget, what's right for what you've planned for. We have seen a lot of clients that select a very nice, very new, very attractive CCRC as part of their investment diversification.
So they actually look at it as if I'm going to have to have it. And some of these are absolutely beautiful. When we say villas, some of them not 10 minutes from where we're sitting have 2,000 square feet and marble and mahogany everywhere. Anybody would be thrilled to live there. So this is not shanty town by a long time. These are places that are safe and secure and truly are beautiful in their own right.
And they're escalating and appreciating in value. Misconception number three is that, well, I'm not going to need any care. I'm 68. I feel great. I'm healthy. I drink a protein shake every morning.
I can still do 13 pull-ups. I'm not going to need any long-term care. Or, you know, the way I hear a lot of people say it is, well, we'll take care of each other, husband and wife. Or, well, I'll just move in with the kids. Or if I can't take care of myself, I'll just go out behind the barn and shoot myself. Or, you know, put me on the top floor of the nursing home if I can't take care of myself. And I'll handle it from there, if you know what I mean. People have a lot of different ways of phrasing it. But at the end of the day, they're all saying the same thing.
It's not going to happen to me. Then that's our third misconception. So to follow up on that with a statistic, anyone over 65 now and into the future, at least half of those folks are going to need some form of long-term care, whether that be just a little bit of help like we provide with home care in the home all the way up to 24-hour care in a skilled nursing facility. And as you age, that percentage gets higher. So the first answer to the misconception is the chances that you're going to need some form of care is really high.
So it is a misconception for sure. And then the fourth and final misconception we'll tackle today is that, well, I'm going to have to move if I need help. I don't want to move. I love my house, but my house isn't really optimized for me to be able to age in place. There's a new movement out there and we see it in the Triangle.
We're very, very lucky to live in this area. There are very specific contractors that actually are starting to focus on retrofitting homes. We kind of jokingly call it senior proofing, but it's not just installing grab bars and maybe widening a door frame to accommodate a wheelchair. These are folks that are really going in and they're doing a lot of zero entry ADA type of American with Disabilities Act type of work to homes to allow people to live there very safely, in fact.
And it's not, again, aesthetic in many cases. It can be going in and totally renovating bathrooms to ensure that they have zero entry, roll-in showers as a capability. It can be redoing kitchens entirely to ensure that if you were or if you found yourself needing a wheelchair, you would still be in a position to be able to prepare meals on your own independently. And even the external framework of the home, we see a lot of ramps that are being built instead of all the front stairways, but with the landscaping and hardscaping they do, it not only looks beautiful from the street, you hardly even notice it. You truly don't even think of it as a, quote-unquote, senior home. It's actually a very, very attractive addition to the home. All of that comes with some cost, but it can be cost that is saved from not entering a true institution or a true facility per se.
Yeah. I mean, you only get the cost of a nursing home or assisted living facility. A one-year stay in one of those places can go a pretty long way in terms of upfitting your home.
So a lot of good options there. So there's the four misconceptions or four misconceptions of aging and healthcare. Matt Ayotte and Alan Milliken are the founders of Aegis Home Care.
And guys, folks can find you online where? www.AegisHomeCare.com, A-E-G-I-S, or the phone number is 919-442-5252. And that's A-E-G-I-S HomeCare.com, AegisHomeCare.com. And again, this is why you have to have a plan within your retirement plan for how you're going to pay for these things. One way or the other, if you need care, it's going to cost you something.
Even if it's a situation where Medicare does pay for some of it, there are going to be out-of-pocket expenses and we have to take those into account. If you'd like some help, by all means, reach out to us. This is Mr. Stilman's Opus. We'll talk with you again very soon. Have a great day.
