I am retiring at the beginning of 2025. I will be 68 and believe I have put enough money aside to supplement my social security and small pension. Still nervous though and while I have partial plans post retirement, I do not know what to do immediately before retirement.
What should I not forget to do before my last day of work? Social security, Medicare, 401K, or just generally.
Update: Thanks for all the great tips!

I was recently asked by my mother to review the portfolio that their financial advisor has them in. My parents retired in 2021. They had about $1m in their retirement accounts when they left their jobs, but of course their portfolio value was inflated due the post-COVID bull period.
Their portfolio is now around $700k. They draw around $4500/month cash from their retirement. They have not been withholding taxes on their IRA withdrawals. 😞
Before they retired they got connected with an advisor that a friend of theirs “has used for years!”
The advisor had them pull everything out of my fathers employer sponsored retirement plan (including converting an old pension worth ~$1300/month which he had them take the cash payout and put in their IRA) and move it into an IRA that he managed for them and picked all the funds for them.
My parents were both unfamiliar with the phrase “expense ratio” until I explained it to them a few weeks ago. The more I dug I the more shocked I was.
Their advisor is charging them 2% of assets under management for his services.
His services amount to: 1. two one-hour long meetings to review their status per year

1. Free filing of their taxes with either 1040A or 1040-EZ (1040 requires an upcharge)
   
2. They did their will (forgot their living will, though)…looks like mine does from Legal Zoom
   
3. Guidance on ACA (they retired before 65), Medicare signup and supplemental plan selection every year
   

Essentially this advisor has my parents heavily in four funds, which are:

1. Direct analog to the S&P 500
   
2. Direct analog to VTIAX
   
3. Some kind of crypto ETF
   
4. Cash equivalent account of about $80k
   

The first three funds were all charging a 1% expense ratio. I didn’t take notes on the specific funds and don’t have my browser history available to go look back on the specific funds.
What am I missing here? Where is the justification for them spending 3% of their assents per year for these services? Is that the going rate?
For context I’ve got my IRA and post-tax investments with Vanguard and use a fiduciary every year to review and guide me which costs me a flat $2k/year. I’m used to seeing <.1% expense ratios.

I took out medicare, stsrted 5/1/24. My supplemental plan is $115/month. I just got an offer to pay $1300 for the year which saves me $500. Question: if I pay yearly, what would happen if I need to change my supplemental at open enrollment? Is there a down side paying yearly?

Sometime in the next six months, I will be choosing a Medicare plan for myself. I'd love to hear from any of you regarding Medicare Parts B or C. I understand that with Part B, you'd need supplemental insurance. It seems like Part C is more "stand alone." Any input? Thanks.

I recently enrolled in Medicare. Part A is straightforward, but the rest have my head spinning. My supplemental plan is ARRP United Health Care through Aetna (that's three names right there). My Part D is Aetna's SilverScript, which means you order your medications through Caremark (three names). Dental is Delta through AARP (two names).
There are so many brand names I don't know where I go for questions. If I have a question about drug coverage, is that Aetna or Caremark? Or is Caremark just the name of the online pharmacy?

I took (37F) my father (70M) to the ER last month where we learned he has a 22 cm invasive rectal tumor that has perforated his gluteal cleft and left some wounding in that area. He needed an emergency diversion colostomy and a nephrostomy due to obstructions. The cancer is stage IV with spread to local lymph nodes. He was 116 lbs at 5’ 8” at the time of admission. A month later he is at 106 lbs so it appears he is continuing to decline. I have him in a rehab facility for wound care. We are hoping to use the 100 days supported my Medicare even though this is costing over 6k a month. Dad requires daily nursing and is mostly bedbound so home health just wouldn’t cut it and the exposed rectal mass is really difficult to clean. There were some spots detected on his liver but they are tiny and their metastatic status could not be confirmed. Dad is having recurrent UTIs from his Foley but his pain is being better managed following our visit with palliative care. They have him on morphine tabs and a buprenorphine patch. He is mentally very sharp but a little sleepier lately from the stronger meds. The palliative wants to meet in 3 weeks to see how he’s doing before we start having logistical conversations about hospice - but that’s where we’re headed. I am worried about being able to afford room and board expenses at a nursing home but still think his needs for skilled nursing do not make home hospice an option. The rate at our current facility is close to $12k for room and board alone. Dad has some cash savings but I worry about Medicaid eligibility because his finances are somewhat of a complex mess. I don’t have a sense of my dad’s timeline. He has a great appetite for food that brings him great pleasure but otherwise he doesn’t consume many calories. He’s not great at drinking supplemental shakes and is continuing to lose weight. I have panic attacks because while I am working on getting his affairs in order - there are moments where I wonder how fast this could go. There are days he suggests I take the day off from visiting him which is so considerate of him but the reality is I worry and feel so guilty and the anticipatory grief can get overwhelming.
Dad has made it clear he does not want to pursue chemo and that he’s content with managing pain and preserving some quality of life (mental faculties, appetite). He tells us he is not afraid of death but is in fact quite curious and interested in it.
I think we will continue to use the palliative care services to exhaust the 100 days Medicare allots for rehab nursing - or as much as we can - before we think about a hospice facility.
For those who have paid room and board at a hospice facility - what have been some typical rates? I think ours is $450 a day. Also - how did you decide it was time for hospice? My best guess is the palliative care docs wanted to stabilize dad’s pain first and then check in again to see if he still feels the same about not pursuing treatment.
I wish I had a better sense of his timeline. I’m an only child and his primary caregiver. Mom passed four years ago unexpectedly from an undiagnosed metastatic cancer so I am reliving a lot of trauma right now.
Caregivers - what have you done to better manage your anxiety?

Was going back and forth … this surgery or a wt loss med ( paying out of pocket for the med) but I now see Medicare even with the best supplement doesn’t pay for this… weird but it pays for bypass .. I don’t qualify for that . Insurance stinks !!!

I recently started a new job within the past 2 months. For the first 4(four) weeks, I was paid a base salary of "x" amount of money per week, plus commission. I no longer receive a base salary given I have been working for over 4 weeks now and am strictly paid a commission % based off of each sale I make, which is paid weekly.
That said, since the first day of work and up until now (no longer receiving a weekly base salary), my commission has been listed and is still categorized on my old paystub as a "Bonus", not to mention withholdings still being taken out of my Soc Security, Medicare, Federal, state Tax, Borough Tax, and LTC. Does this seem correct? I thought commission was categorized as supplemental income taxed at a 22%.
Thank you all for your input - please reach out if you have any questions.

Hey y'all, so as the title says, my Dad recently passed away out of nowhere. It was completely unexpected, and we're all still just in shock. I'm trying to figure out my Mom's finances, to try and help her not just be in ruins. The down and dirty of it, she is 63 and retired early (so doesn't qualify for Medicare yet, she's on some weird bridge/supplemental health insurance until she turns 65), she gets $2500/mo in social security - this is her only income currently. She has about $36k in debt from a couple of personal loans (one through Citi, the other through Idaho Central Credit Union) I've got her house on the market, and it has roughly $200k in equity if we can get it sold. It's just my Mom and me, no other family. Her and my Dad lived in Idaho, I live in Georgia. I was able to get her a rental here in GA, and have all her stuff moved here. So that's good. My plan was to use some of that equity to erase the loans, and take whatever is leftover and dump that into her retirement Roth IRA, which sadly, is very little ($75k). I want to try to grow her money, so she has a little bit of retirement or can live a little more comfortably. Any advice here would be immensely helpful, I'm not very experienced with money (I know, I'm feeling terribly ignorant).

TL;DR: 85 yo Mom’s NW $6.5 million, gets mediocre paid advice from CPA / attorney / FA; should I find someone else to help her or since I’m likely the main beneficiary, should I just continue to be more involved and help?
——
Mom is 85yo, good health, NW around $6.5 million, invested about 50/50 stocks/bonds, age at death in her family usually over 100. Owns her home outright, worth about $550,000. Yearly spend is barely $40,000, and that includes her Medicare supplemental stuff. Everything she owns is in a revocable trust. She lives simply.
I think she’s been getting lackluster guidance from every finance/estate/law/tax professional in her life and am trying to figure out how to help her better with this OR find the right people to help her.
Her goals with her estate are to minimize estate taxes, leave most/all of her estate to me and about 10% of it to my sister, and have enough to pay for LTC for herself.
She’s currently gifting me and my spouse $18,000/year each. And I can occasionally get her to write a check to my sister as well. She is terrified she will outlive her money, and is always sending me articles like “SHOCKING: Sally Joe in Oklahoma only saved $80,000 for retirement and can’t afford her $50,000/yr nursing home.”
Tax Issues:
Her CPA, also a JD specializing in tax law (until he retired last year) was painfully unhelpful. He’d prepare her taxes but provided no guidance on tax strategy. Her investments spin off realized gains/losses from dividends and interest so some years she’ll have $450,000 in realized gains, then the next year $150,000 in realized losses. Her CPA was following the 110% safe harbor estimated taxes thing, so she’d end up chronically underpaying or overpaying, then get really annoyed at him about that. Last year she was due nearly $45,000 in refunds, but her CPA just rolled that forward to the next year’s tax liability without telling her.
So I called up her Financial Advisor (AUM model, sub 0.75% fees), and asked “hey, can we come up with quarterly predicted income forecasts so that we can pay estimated taxes in a more reality-based way?” And he was like “oh yeah, no problem,” and started generating quarter end reports that we can base estimated payments on.
Also, for as much as she complains about capital gains, no one ever said “hey, you can ask to to not realize as many gains,” and then explained what impact that might have. But when I lived in a city/county with high taxes that kick in over a certain income level, and I had no problem asking our FA (same as my mom) to limit realized cap gains to avoid getting above that threshold when we lived there.
Lawyer issues:
My mother has spend close to $30,000 on an estate lawyer to help rewrite her will. This person has jacked her fees from $180/hr when they first started together 3 years ago, to $600/hr now - the biggest jump happening when the attorney found out my mom’s NW. Doing something as simple as reducing my sister’s share of ONE account cost $2,500, including the time it took for the lawyer to write a letter for my mom to sign saying that the lawyer recommended AGAINST unequal shares.
Yet this lawyer has provided zero guidance around keeping taxes low, avoiding estate taxes, how to handle gifting, etc. And this lawyer pushed for she herself (the attorney) to be the executor of my mom’s estate. I tried repeatedly to explain I can handle selling her condo and closing her very simple estate but mom thought I couldn’t/wouldn’t be able to handle it.
Thankfully my uncle stepped in and assured her I can. He also explained she should have everything in an irrevocable trust to pass on her fortune without estate taxes. But I don’t understand why her lawyer wouldn’t have suggested this? After all this lawyer also creates trusts for people.
I should point out this is maybe the third or fourth estate lawyer she’s had. The previous one charged about $10,000 for a one hour meeting to generate a will that was riddled with errors, had other client’s names in it, didn’t capture my mom’s wishes, etc.
Estate Planning:
Since her CPA retired, I’ve started helping her do her taxes.
She could be reducing her tax burden through charitable donations (she has a list of about $200,000 in donations she wants to make when she dies, which we could start chipping away at now), and through 529 contributions to my sister’s children, since she lives in a state where that would be tax deductible.
Why was no one - CPA, lawyer - suggesting these things to her?
She lives in a state with a $4mil estate tax floor. Why did her estate lawyer not suggest she get her assets below that ASAP / ever?
I’ve worked through some tools like ProjectionLab, and she needs to start giving away more soon or she may quickly be above the Federal estate tax level. I’ve modeled several scenarios, trying to have her die at 105 with as close to zero as possible, and she’ll have to be VERY generous to make that happen.

https://twitter.com/isSCS4me/status/1742558882222760018
The following publication is further evidence of SCS inefficacy for opioid
reduction and potential treatment cost analysis. It compares conventional
medical management(CMM) versus SCS.
https://jamanetwork.com/journals/jamaneurology/article-abstract/2799084
"Long-term Outcomes in Use of Opioids, Nonpharmacologic Pain Interventions,
and Total Costs of Spinal Cord Stimulators Compared With Conventional Medical
Therapy for Chronic Pain
...
Key Points
Question What are the outcomes among real-world patients with chronic pain who
are treated with spinal cord stimulators compared with conventional medical
management?
Findings
In this propensity-matched comparative effectiveness research analysis of 7560
insured individuals, treatment with a spinal cord stimulator was not associated
with a reduction in use of opioids, pain injections, radiofrequency ablation,
or spine surgery at 2 years. Approximately one-fifth of patients treated with
spinal cord stimulators experienced complications and required device revision
or removal.
Meaning
Study results suggest that use of spinal cord stimulators is not associated
with reductions in opioid use or nonpharmacologic pain interventions.
Abstract
Importance Spinal cord stimulators (SCSs) are increasingly used for the
treatment of chronic pain. There is a need for studies with long-term follow-up.
Objective
To determine the comparative effectiveness and costs of SCSs compared with
conventional medical management (CMM) in a large cohort of patients with
chronic pain.
Design, Setting, and Participants
This was a 1:5 propensity-matched retrospective comparative effectiveness
research analysis of insured individuals from April 1, 2016, to August 31, 2018.
This study used administrative claims data, including longitudinal medical and
pharmacy claims, from US commercial and Medicare Advantage enrollees 18 years
or older in Optum Labs Data Warehouse. Patients with incident diagnosis codes
for failed back surgery syndrome, complex regional pain syndrome, chronic pain
syndrome, and other chronic postsurgical back and extremity pain were included
in this study. Data were analyzed from February 1, 2021, to August 31, 2022.
Exposures
SCSs or CMM.
Main Outcomes and Measures
Surrogate measures for primary chronic pain treatment modalities, including
pharmacologic and nonpharmacologic pain interventions (epidural and facet
corticosteroid injections, radiofrequency ablation, and spine surgery), as
well as total costs.
Results
In the propensity-matched population of 7560 patients, mean (SD) age was 63.5
(12.5) years, 3080 (40.7%) were male, and 4480 (59.3%) were female. Among
matched patients, during the first 12 months, patients treated with SCSs had
higher odds of chronic opioid use (adjusted odds ratio [aOR], 1.14; 95% CI,
1.01-1.29) compared with patients treated with CMM but lower odds of epidural
and facet corticosteroid injections (aOR, 0.44; 95% CI, 0.39-0.51),
radiofrequency ablation (aOR, 0.57; 95% CI, 0.44-0.72), and spine surgery
(aOR, 0.72; 95% CI, 0.61-0.85). During months 13 to 24, there was no
significant difference in chronic opioid use (aOR, 1.06; 95% CI, 0.94-1.20),
epidural and facet corticosteroid injections (aOR, 1.00; 95% CI, 0.87-1.14),
radiofrequency ablation (aOR, 0.84; 95% CI, 0.66-1.09), or spine surgery
(aOR, 0.91; 95% CI, 0.75-1.09) with SCS use compared with CMM. Overall, 226 of
1260 patients (17.9%) treated with SCS experienced SCS-related complications
within 2 years, and 279 of 1260 patients (22.1%) had device revisions and/or
removals, which were not always for complications. Total costs of care in the
first year were $39 000 higher with SCS than CMM and similar between SCS and
CMM in the second year.
Conclusions and Relevance In this large, real-world, comparative effectiveness
research study comparing SCS and CMM for chronic pain, SCS placement was not
associated with a reduction in opioid use or nonpharmacologic pain interventions
at 2 years. SCS was associated with higher costs, and SCS-related complications
were common.
...
Despite the increasing utilization of SCSs, there are limitations to the
evidence supporting its superiority over usual care, which includes conventional
medical management (CMM).6 Most SCS have been authorized by the US Food and Drug
Administration (FDA) without clinical data.7 Approximately 85% of large studies
of SCSs (ie, >100 patients) are industry funded.8 Independent evaluations have
generally been small, single-center, and nonrandomized.9
...
Eligible individuals were 18 years or older with an incident diagnosis of
failed back surgery syndrome, complex regional pain syndrome, chronic pain
syndrome, and other chronic postsurgical back and extremity pain (for the
latter diagnosis, history of spine surgery within 6 months of diagnosis was
required) between April 1, 2016, and August 31, 2019 (eTable 1 in the
Supplement for codes reviewed by multiple authors).9,16-18
...
SCS-Related Complications and Removal
Among the 1260 patients treated with SCS, 226 (17.9%) experienced complications
within the first 2 years after placement (Table 4). These complications included
breakdown, displacement, other mechanical complications, and infection of the
lead and/or generator. During the first 2 years, 279 patients (22.1%) had an
SCS removal and/or revision; 126 (10%) of these were in the absence of a
complication, suggesting lack of effectiveness.
...
"
The one editorial is worth your effort reading.
https://jamanetwork.com/journals/jamaneurology/article-abstract/2799086
"
While spinal cord stimulation (SCS) to treat multiple chronic pain indications
has been rapidly gaining popularity over the last decade, evidence of clinical
and public health effectiveness is limited due to small sample sizes or bias
related to authors that receive income from SCS manufacturers.
...
"
There are several critiques of the publication. Please use Google Scholar. I
advise using caution when reading because the source of the critique can be
conflicting.
I recommend reading the publication.

Hello all:
You don’t know, what you don’t know - and I’m hoping this post will fill in the gaps for me.
I’m currently 32 YOA, have vested in a state pension that will give me approximately $600 a month at the age of 60. I have currently saved 150K for retirement, 11K of that being in a ROTH.
Just accepted a federal position, in a special provision FERS law enforcement designated position. It’s my understanding my FERS contribution is 4.9%, but I get a multiplier of 1.7x on my high 3 and can retire after 20 years of service. It’s also my understanding that I would be eligible for a SS supplement between 52-62 of 1/2 of what I qualify for in terms of social security if I were to draw at 62.
I will be maxing out TSP, 2/3 traditional and 1/3 ROTH in mostly C Fund. I’m opting for MHBP Consumer HDHP insurance to get the HSA option and the contribution.
I understand that I get FEHB into retirement? But don’t understand the significance per se. Does the government pay a portion? Is there any benefit to keeping it past 65 once I qualify for Medicare?
What else am I missing?

TLDR: mom is retiring and dad is insured through her, it would cost an additional $390/mo to keep him on this insurance. The difference in cost would pay for Part B, Medigap N/F-HD, and Part D. Is Original Medicare plus D and Medigap superior to most insurances? He has underlying conditions and just started Part B through the special enrollment period due to his insurance ending.
Hello all! I’ve been lurking in this group and learned a good deal. I’ll start with some background and appreciate any guidance. Thank you
My parent’s insurance is through my mom’s employer and she is retiring. My mom will be able to keep her insurance and my dad is able to as well. My understanding is that their plan requires them to sign up for Part B and will reimburse the premium through her pension. The cost to continue insurance through this plan is about $120/mom for my mom and about $510/mo for the both of them. She is able to convert her sick/personal time to help cover some of these costs.
When calculating the difference, the thought is that it essentially costs $390 ($215 if they reimburse Medicare Part B premium) to insure my dad through this plan. The plan is through UHC and there is a large network nearby them. They pay about $20-25 copays to see a specialist and maybe $20-25 for labs. He goes to see his various doctors about total of 12 times per year plus labs quarterly.
I have read that Original Medicare may be better than MA and I am not sure how their current plan compares to MA. My dad has underlying conditions (heart disease, diabetes) and could get on a Medicare Supplement through the special enrollment period (he just got Part B effective May 2024) since the group employer insurance is ending. He would likely not qualify or the premiums would be super high if done outside this time.
I was thinking that Plan N is roughly the same cost when he visits his doctors but his network opens up. It is also cheaper as Plan N is roughly half the cost of the $215 difference if he were to stay on my mom’s plan. I understand that the supplement premium is reassessed every year and will climb. I think my mom’s plan has been relatively stable. He would also need to sign up for Part D and his total costs (premium plus drugs) ranges from $50-140/mo based on his current medications.
Does this logic make sense? Am I missing anything?
Wild card: also considering F-HD as the cost is currently ~$40/mo. It seems like his copay would be just a little over the flat copays of N. He would be subject to at most $2800 out of pocket. He does not have an HSA but I could help with mine when/if needed. If this doesn’t work out after a few years, could he switch to N without a medical exam?
Appreciate any insights! Thanks for reading

Hi, guys! I am helping a friend apply for a Medicare Supplement in Iowa. I am doing this in an unofficial capacity since I am not licensed to write in Iowa. The Iowa application is not as straightforward as the other states I work with.
She is eligible for Medicare 6/1 due to permanent disability. Since she is newly eligible, she is in her initial enrollment period. Section C and D of the application are really throwing me. Looking at the application I am checking yes on C2, but I can't check yes on C3 since she is NOT 65 and not turning 65. If I go down to section D after that, I don't see any of the situations that clearly state- I am newly eligible for Medicare so I can apply now.
She is currently on her husband's work insurance and they will be terminating that once her supplement is approved. I would appreciate any help that can be offered!

I've decided that I'm going to go with Medicare A, B, D, and supplemental insurance plan N.
How do I go about purchasing a plan N? Do I just call up each insurance company and ask for their premiums and enroll over the phone? My understanding is that the coverage benefits are all the same: Company A's plan N will be the same as company B's plan N.
But are there any other considerations such as customer service or reputation or something like that?
The two insurances that are in my area is Humana and United Healthcare. Does anyone have any experience with them: good or bad?

Hi all! I think I am just looking for mostly reassurance at this point regarding taking care of my grandma. Here is my situation (buckle up, this is a long one):
I was estranged from my biological father and his family from my teen years until about 2 years ago. Long story short, my parents got divorced when I was 2, my mom moved me out of state when she married my stepfather and I spent every summer in childhood visiting my father's family. For context, I am the only child of my father (my mom had other children from a later marriage, my half siblings, my father never had any more kids). Around my teen years, those visits stopped and I just kept in contact with my biological grandmother on my dad's side through the occasional letters over the years. I have a lot of resentment toward my parents for their poor decision making and how it's affected so much of how I act in my relationships as an adult. I have sought out therapy and am doing my best to recover.
In May of 2022, I received a phone call from my paternal grandma (who was 97 at the time), which was so unusual and very nerve-wracking because she never called me, we only communicated through letters. She told me that my father was very sick but couldn't give me many details. She was very hard of hearing and knew nothing about his illness except that it was a "blood disease." My father had been divorced 3 times and after the 3rd one, he moved in with my grandma and they were great friends. I think it was a good arrangement for them both. After that phone call, I did a lot of thinking and soul searching and decided that I should visit my father.
My husband (who never met this side of my family) and I visited my father and grandma later that month. I was shocked at their condition. My father never got up from his chair and looked so frail and sick. My grandma was actually in better health than him despite her age, but she still obviously couldn't care for him in his sickness. She could barely get up from her chair and was very unsteady walking around. I tried to get details from my father about his health but he was confused and unable to tell me anything concrete. But he did tell me that hospice was coming to see him the next day. So we came back the next day to be there when the hospice intake nurse came. He was even more confused the next day, couldn't spell his middle name or answer questions clearly. I did my best to answer questions (even though I barely knew him since we had been estranged for so long) and provided my phone number as a contact for them. It was all incredibly overwhelming. That meeting ended with my father wanting a little more time to think about it before being officially admitted to hospice. My husband and I went back home and I was overwhelmed about everything.
A few days later, I got a phone call from hospice. My father had reached a point where he was incontinent and belligerent and my grandma called the phone number on the card the hospice worker had left from her visit because she was desperate for help. I was suddenly thrust into a situation of trying to make decisions for a man I barely knew states away. It was obvious my 97 year old grandmother could no longer care for him at home, so he was taken to the hospital. I was able to talk with his doctor over the phone who told me that he had leukemia. The treatment he had been receiving was not working and he estimated that my father had 6 weeks to live. He would be admitted to an inpatient hospice facility until he died. I barely was able to process that because there was another huge issue: who is going to look after my grandma after he dies?
(A little more family background here: my father has an older brother who lives out of state. The two brothers never got along and from what I hear, my uncle had the tendency to rub people the wrong way. My uncle only communicated with his mother - my grandma - through the occasional birthday and Christmas card. That uncle has 2 kids, my cousins, who live in the same state as my uncle. The older cousin calls my grandma once in a while. My grandma has distant relatives who live about 45 minutes away and visit very occasionally.)
My husband and I talked a lot and I decided that I needed to go and stay with my grandma while my dad was in hospice. I was able to work remotely and so was my husband, so we made the drive back to my grandma's house and stayed with her, taking her to visit my dad every day, cooking, cleaning, etc.
My dad died on May 31, 2022, only about a week after he was admitted to hospice. I handled all the logistics and planning of the funeral. My grandma, who was totally competent mentally, was stone cold deaf and emotionally unable to handle any of it, so I was left to do everything, despite barely knowing him and not really having the chance to process my own very complicated grief at losing an estranged parent. Fortunately he had the wisdom to take out a life insurance policy years before with me as the beneficiary and I was able to pay for the funeral with that money.
And instead of his death being the end of something, it was the beginning of the most stressful time in my adult life. I spent day and night looking into care options for my grandma. We finally got her some hearing aides (something my father never thought to do for her I guess) and I spent hours on the internet, researching what is covered by Medicare, if she was eligible for Medicaid, etc. I called her state's agency for aging, multiple home health aide companies, the works. We had to go back to our home state to resume our lives, and all the while, my mental energy was spent on worrying about her and running through every option for care over and over again.
And here we are, TWO YEARS LATER. My grandma is now 99 years old at the end of this month. In May of last year, my husband very unexpectedly and heartbreakingly lost his job of 12 years. After that happened, we decided it was time to pick up our lives and move in with my grandma. While we were living in our state and she alone in hers after my dad died, I called her pretty much every day to check on her. I was constantly anxious and on edge. We visited her as much as we could but it is a long drive and we couldn't always put our lives on hold to visit her.
We moved in in December. And it has absolutely been one of the hardest times of my life. My husband and I are in dire straits financially (he is still struggling to find consistent work and my work is seasonal, we're just getting into my busy season but honestly, I don't make a lot of money). My grandma can still barely hear with her hearing aides in so I always have to raise my voice to talk to her and repeat myself multiple times. I spend hours of my time taking her to doctor's appointments (which is not an easy feat because she is wheelchair bound outside of the home), on the phone with doctors, picking up medicine, etc. I feel constant pressure to make sure she cared for. Overall she is a pleasant person but she is also a master of Italian Catholic guilt and passive aggressiveness. There is no one else to help us. I feel like I am slowly dying inside little by little every day.
So if you've made it this far, here is where I am looking for reassurance. We have to go back to our home state multiple times this summer for family obligations and my work (I am a wedding photographer and contracted to photograph weddings this summer back home). For example, at the end of May, we have to be gone for over 2 weeks to go to multiple graduations of nieces and nephews, open houses, etc. And I feel extremely guilty for leaving.
Here is more about my grandma and her current status for context:

• She is perfectly coherent mentally. Totally capable of taking her own medicine (which is not too much considering her age).
• She has a shower aide come once a week to help her in the shower. She has a walk in shower with a chair and extendable shower head. She also had handles on the toilet we recently installed. She dresses herself every day.
• She is unsteady on her feet but relies on her walker in the house. She is good about using it and doesn't go without it.
• She still cooks a little, uses the stove to boil vegetables, etc. Uses the microwave for her instant coffee, soups and TV dinners. I cook dinners regularly and she will often eat what I make.
• She has Medicare and supplemental insurance. She is not eligible for Medicaid. She owns her house outright and has about $60,000 in savings. She is unwilling to pay for private home health aides to come in our absence and unfortunately, my husband and I cannot afford them.
• She was on hospice care after my dad died. Her PCP knew the situation, that she would be alone, so she referred to us to hospice so she would at least have a nurse check on her once a week. It was extremely hard to get her admitted and she was able to stay on their service up until a few weeks ago, when they booted her because she is not deteriorating. I understand that hospice is for end of life care and just because someone is 99 it doesn't mean they automatically qualify. But it's a little scary losing that safety net.
• I tried to enroll her in VA benefits because her husband was a veteran. They denied her because she makes too much in social security every month.
• She hates being alone and has brought up multiple times how worried she is to be alone while we're gone.

Here are the things we have set in place to help care for her in our absence:

• We have one camera set up in the living room where she spends most of her time. Only my husband and I can access the camera remotely via our phones when needed to check on her. I am going to talk to her about installing 2 more, one in the kitchen and one in her bedroom.
• She has a Life Alert that she wears around her neck. She very good about wearing it all the time.
• Her shower aide will be here once a week.
• She has 2 neighbors who are great about checking in on her when needed. They both have keys to the house. I also have a group text of a handful of people in the area she is friends with who have keys to the house and can come over in an emergency. I am going to text everyone to let them know the dates we will be gone and ask them to call and check on her regularly.

So my question is this: is this enough? Can I leave her and not feel guilty? I've spent countless hours and tears struggling with this question.
(Thank you to all of you who read all this and my prayers are with you on your own caregiving journeys!)

Hi all! I think I am just looking for mostly reassurance at this point. Here is my situation (buckle up, this is a long one):
I was estranged from my biological father and his family from my teen years until about 2 years ago. Long story short, my parents got divorced when I was 2, my mom moved me out of state when she married my stepfather and I spent every summer in childhood visiting my father's family. For context, I am the only child of my father (my mom had other children from a later marriage, my half siblings, my father never had any more kids). Around my teen years, those visits stopped and I just kept in contact with my biological grandmother on my dad's side through the occasional letters over the years. I have a lot of resentment toward my parents for their poor decision making and how it's affected so much of how I act in my relationships as an adult. I have sought out therapy and am doing my best to recover.
In May of 2022, I received a phone call from my paternal grandma (who was 97 at the time), which was so unusual and very nerve-wracking because she never called me, we only communicated through letters. She told me that my father was very sick but couldn't give me many details. She was very hard of hearing and knew nothing about his illness except that it was a "blood disease." My father had been divorced 3 times and after the 3rd one, he moved in with my grandma and they were great friends. I think it was a good arrangement for them both. After that phone call, I did a lot of thinking and soul searching and decided that I should visit my father.
My husband (who never met this side of my family) and I visited my father and grandma later that month. I was shocked at their condition. My father never got up from his chair and looked so frail and sick. My grandma was actually in better health than him despite her age, but she still obviously couldn't care for him in his sickness. She could barely get up from her chair and was very unsteady walking around. I tried to get details from my father about his health but he was confused and unable to tell me anything concrete. But he did tell me that hospice was coming to see him the next day. So we came back the next day to be there when the hospice intake nurse came. He was even more confused the next day, couldn't spell his middle name or answer questions clearly. I did my best to answer questions (even though I barely knew him since we had been estranged for so long) and provided my phone number as a contact for them. It was all incredibly overwhelming. That meeting ended with my father wanting a little more time to think about it before being officially admitted to hospice. My husband and I went back home and I was overwhelmed about everything.
A few days later, I got a phone call from hospice. My father had reached a point where he was incontinent and belligerent and my grandma called the phone number on the card the hospice worker had left from her visit because she was desperate for help. I was suddenly thrust into a situation of trying to make decisions for a man I barely knew states away. It was obvious my 97 year old grandmother could no longer care for him at home, so he was taken to the hospital. I was able to talk with his doctor over the phone who told me that he had leukemia. The treatment he had been receiving was not working and he estimated that my father had 6 weeks to live. He would be admitted to an inpatient hospice facility until he died. I barely was able to process that because there was another huge issue: who is going to look after my grandma after he dies?
(A little more family background here: my father has an older brother who lives out of state. The two brothers never got along and from what I hear, my uncle had the tendency to rub people the wrong way. My uncle only communicated with his mother - my grandma - through the occasional birthday and Christmas card. That uncle has 2 kids, my cousins, who live in the same state as my uncle. The older cousin calls my grandma once in a while. My grandma has distant relatives who live about 45 minutes away and visit very occasionally.)
My husband and I talked a lot and I decided that I needed to go and stay with my grandma while my dad was in hospice. I was able to work remotely and so was my husband, so we made the drive back to my grandma's house and stayed with her, taking her to visit my dad every day, cooking, cleaning, etc.
My dad died on May 31, 2022, only about a week after he was admitted to hospice. I handled all the logistics and planning of the funeral. My grandma, who was totally competent mentally, was stone cold deaf and emotionally unable to handle any of it, so I was left to do everything, despite barely knowing him and not really having the chance to process my own very complicated grief at losing an estranged parent. Fortunately he had the wisdom to take out a life insurance policy years before with me as the beneficiary and I was able to pay for the funeral with that money.
And instead of his death being the end of something, it was the beginning of the most stressful time in my adult life. I spent day and night looking into care options for my grandma. We finally got her some hearing aides (something my father never thought to do for her I guess) and I spent hours on the internet, researching what is covered by Medicare, if she was eligible for Medicaid, etc. I called her state's agency for aging, multiple home health aide companies, the works. We had to go back to our home state to resume our lives, and all the while, my mental energy was spent on worrying about her and running through every option for care over and over again.
And here we are, TWO YEARS LATER. My grandma is now 99 years old at the end of this month. In May of last year, my husband very unexpectedly and heartbreakingly lost his job of 12 years. After that happened, we decided it was time to pick up our lives and move in with my grandma. While we were living in our state and she alone in hers after my dad died, I called her pretty much every day to check on her. I was constantly anxious and on edge. We visited her as much as we could but it is a long drive and we couldn't always put our lives on hold to visit her.
We moved in in December. And it has absolutely been one of the hardest times of my life. My husband and I are in dire straits financially (he is still struggling to find consistent work and my work is seasonal, we're just getting into my busy season but honestly, I don't make a lot of money). My grandma can still barely hear with her hearing aides in so I always have to raise my voice to talk to her and repeat myself multiple times. I spend hours of my time taking her to doctor's appointments (which is not an easy feat because she is wheelchair bound outside of the home), on the phone with doctors, picking up medicine, etc. I feel constant pressure to make sure she cared for. Overall she is a pleasant person but she is also a master of Italian Catholic guilt and passive aggressiveness. There is no one else to help us. I feel like I am slowly dying inside little by little every day.
So if you've made it this far, here is where I am looking for reassurance. We have to go back to our home state multiple times this summer for family obligations and my work (I am a wedding photographer and contracted to photograph weddings this summer back home). For example, at the end of May, we have to be gone for over 2 weeks to go to multiple graduations of nieces and nephews, open houses, etc. And I feel extremely guilty for leaving.
Here is more about my grandma and her current status for context:

• She is perfectly coherent mentally. Totally capable of taking her own medicine (which is not too much considering her age).
• She has a shower aide come once a week to help her in the shower. She has a walk in shower with a chair and extendable shower head. She also had handles on the toilet we recently installed. She dresses herself every day.
• She is unsteady on her feet but relies on her walker in the house. She is good about using it and doesn't go without it.
• She still cooks a little, uses the stove to boil vegetables, etc. Uses the microwave for her instant coffee, soups and TV dinners. I cook dinners regularly and she will often eat what I make.
• She has Medicare and supplemental insurance. She is not eligible for Medicaid. She owns her house outright and has about $60,000 in savings. She is unwilling to pay for private home health aides to come in our absence and unfortunately, my husband and I cannot afford them.
• She was on hospice care after my dad died. Her PCP knew the situation, that she would be alone, so she referred to us to hospice so she would at least have a nurse check on her once a week. It was extremely hard to get her admitted and she was able to stay on their service up until a few weeks ago, when they booted her because she is not deteriorating. I understand that hospice is for end of life care and just because someone is 99 it doesn't mean they automatically qualify. But it's a little scary losing that safety net.
• I tried to enroll her in VA benefits because her husband was a veteran. They denied her because she makes too much in social security every month.
• She hates being alone and has brought up multiple times how worried she is to be alone while we're gone.

Here are the things we have set in place to help care for her in our absence:

• We have one camera set up in the living room where she spends most of her time. Only my husband and I can access the camera remotely via our phones when needed to check on her. I am going to talk to her about installing 2 more, one in the kitchen and one in her bedroom.
• She has a Life Alert that she wears around her neck. She very good about wearing it all the time.
• Her shower aide will be here once a week.
• She has 2 neighbors who are great about checking in on her when needed. They both have keys to the house. I also have a group text of a handful of people in the area she is friends with who have keys to the house and can come over in an emergency. I am going to text everyone to let them know the dates we will be gone and ask them to call and check on her regularly.

So my question is this: is this enough? Can I leave her and not feel guilty? I've spent countless hours and tears struggling with this question.
(Thank you to all of you who read all this and my prayers are with you on your own caregiving journeys!)

I'm a Medicare Telesales (captive) agent for a large health insurance company. I'm doing fairly well, not the best on my team but not the worst, but I DO know that I hold leadership qualities that some do, and some do not possess. I really love my job, I love the my colleagues, and I really want to move up in my career.
I have not been in school for 10+ years... I am honestly not even sure how going back to college would even work, entirely. I am a single mom of a four year old boy who's in preschool full time. (just to give a little background and knowledge of my very limited schedule)
What classes should I take in order to make myself stand out ahead of anyone else who may be aiming for the same leadership roles, such as supervisor or lead? Bachelors in Heth Sciences?
Any helpful advice/insight would be IMMENSELY appreciated. Thank you!

Hi all I recently got my 2-15 license. I currently have a job in another sales industry that lets me live comfortably off of part time hours and I love it and am committed to it. I want to get supplemental income to get ahead. I am looking for remote work where I can make my own schedule with leads provided. Any advice or companies come to mind? Ive seen some ACA jobs like that but am wondering if that's a good avenue to go down or if y'all know of health/life or Medicare agencies that work like that or that you recommend. Im in Orlando Florida and I'm not looking to be buying leads or out networking or cold calling door knocking etc

I know that in 2025 the prescription drug cap is basically going to be $2,000, but I see Medicare doesn't cover Actemra, so it depends on your insurance plan.
My parents make in the $70,000 range a year and use Medicare. They've relied on the Genetech patient assistance foundation, but evidently with the out-of-pocket maximum going way down in 2025 that will no longer be an option.
I guess I'm just worried that they're going to have to get some really expensive insurance plan to get her Actemra covered. So even if the max for Rx is $2,000 they're going to be paying through the nose for a part D supplement that cost them all kinds of money in order to find one that covers Actemra.
Can anyone shed any light on this? We're really worried about very high costs coming next year.
We're also open to the option of her getting infusions or even changing to that new biosimilar. We just don't want them crippled by medical costs.