Empowering Patients
McClanahan accompanies patients with very serious illnesses—such as cancer, new-onset dementia and ALS—to medical appointments. “They appreciate me being a third ear and brain,” she says. Yet like Rand, she knows that clients must make their own decisions and is careful not to overstep professional boundaries.

McClanahan uses age 100 as a projection when wealth-planning for healthy clients with healthy lifestyles. But if clients have multiple health issues or don’t think they’ll live long, “I don’t want to pick a number out of the air,” she says. Instead, she has them answer in-depth questions on the Living to 100 Life Expectancy Calculator.

To calculate clients’ potential medical expenses, she uses average figures from the Employee Benefit Research Institute that include Medicare premiums (Parts B and D), Medigap premiums and out-of-pocket drug expenses.

McClanahan puts clients in the 10th, 50th or 90th EBRI cost percentile based on whether they are low or high users of health care. An elderly but very healthy client who rarely goes to the doctor may be in the 10th percentile. Clients in the 90th percentile “go to the doctor every time their rear end itches and they have a hangnail,” she says.

Long-term care isn’t included in the EBRI numbers. McClanahan adds in two years for unhealthy clients and five years for healthy clients with healthy lifestyles. The latter are more likely to get dementia before their bodies deteriorate, she says.

She also encourages clients to take care of their health, retain copies of medical records and communicate with doctors. Writing down questions and the history of a medical problem to bring to appointments, especially with new doctors, is more likely to result in satisfactory patient-doctor interactions, she says.

Although Life Planning Partners doesn’t generally deal with clients’ medical bills, “if there is a serious illness we kind of go into triage mode,” says McClanahan. She encourages all clients to track expenses using her firm’s eMoney portal. Organizing health-related expenses can save much time and money down the road, she says.

People are often unaware that home health care, trips to receive medical care and the retrofitting of homes to make them friendly to those with medical problems (by widening doors and installing ramps and grab bars) are deductible expenses, she says.

Last year, Life Planning Partners made every client fill out a quality-of-life directive. This year, it is creating documents that let clients spell out their preferred long-term care scenarios. It is also creating agreements aimed at preventing squabbles within families and protecting family members who quit work to be caregivers.