(Guest Lecture): November 2022 - Preparing for Survivorship Financially

Diana is a financial program manager and she specializes in financial help for myeloma and AML patients. As a professional financial consultant and former caregiver of her husband who was diagnosed with multiple myeloma, Diana perfectly understands the financial issues facing myeloma patients. John R. Borland, CLU CHFC has been an active financial planner for over 35 years. Formerly from Vermont, he now lives in Florida. He was diagnosed with multiple myeloma in 2019 and began treatment under the supervision of a myeloma specialist at the Mayo Clinic. He is grateful for having achieved a stringent complete response without stem cell transplant and remains on a maintenance program. John is trained as a myeloma coach with HealthTreat and he offers his professional expertise and personal experience to support other myeloma patients nationwide. Diana and John both serve as coaches as mentioned and they are willing to help you through our free myeloma coach program which we will talk about towards the end of the presentation. So now as you know, the topic is preparing for survivorship financially. And as I mentioned today, we're going to have a discussion about how to prepare financially to live long term with cancer while assessing survivor needs. Diana is going to be giving a brief introduction of herself. John will introduce himself briefly and they'll both kind of talk about what survivorship means to them and then start that educational conversation while they'll ask each other questions like how did you budget long term in your myeloma journey and how did you and your partner's availability to work affect your finances long term as well as other important questions. So with that being said, Diana, I'll turn the time over to you and then you and John can start your conversation. I think you're muted, Diana, so if you want to unmute yourself. No problem. And John, you too. Thanks for introducing, Audrey, and thanks for everyone who decided to join us. This is very important. John and I are both financial advisors and John's been in it a few years longer than I have. John and I have only been in it a little bit 22 years. He's been at 35 quite a few years longer. So we are acutely aware of how finances need to be driven when you have an acute or chronic illness. And I'm going to come at this from a caregiver perspective. I was younger, 10 years younger than my husband, and that can make a significant financial impact on your financial lives. And I also had children that were younger in private school and we still had preparing for college for them. So I'm going to come at it from that perspective and John's going to come at it from a patient perspective. So I want to go over a couple of definitions of survivorship. When I was at Salt Lake City, I went to the roundtable recently and survivorship, that became a title of discussion. What does that mean? And that has changed quite a bit, especially in the myeloma community, because people are living longer. And again, it is becoming more of a chronic disease versus a terminal one. The historical definition would include just family members, family members who survived the loss of a loved one to cancer. Again, that is just after someone passes. But again, we're looking at people who are living longer, much longer lives. The Centers for Disease Control and Prevention defines it as anyone who has been diagnosed with cancer for the time of diagnosis through the balance of his or her life, which is a little bit more current and more accurate as to what we are going to be talking about today. So I would like to start from a patient perspective because a majority of people here are patients or they're taking care of patients. And we're going to get into my side a little bit later. But, John, if you could give me an idea of what survivorship means to you from a patient perspective. Thank you, Diana. And thank you for the introduction. I once heard a story a friend of mine told me, and he said, this is what it's like to get cancer and be told you have cancer. He said, you know, imagine you're sitting at home watching TV and everything's fine and you feel a little hungry. So you go to the refrigerator for a snack and you open the door and there's a mountain lying in your refrigerator. That's somewhat a universal reaction that I get as I get older. And I get as I know in my life and as I talk to other patients around the country, most of us, many of us may not have had much many symptoms. We may not. We may have had symptoms that were confused by other diagnoses. And then we finally get the diagnosis and we find out we have something called multiple myeloma, which we may or may not have heard about. So what does that mean? Instantly, I know for myself, I kind of went numb with shock and I'm not someone who reacts very emotionally about many things. So my tendency is to hold it in. But of course, my wife and I immediately went to the we learned with a phone call on a Friday afternoon and the doctor said, call me next week and we'll get you in here for treatment. And we immediately went to the Internet. And what we saw financially was terrible. We heard about people spending one hundred thousand dollars and hundred fifty thousand dollars. And my wife, who loves to ride and loves, loves her horse. And we're down here in Florida because of it. I found out later that she decided to sell her horse without even talking to me because she thought that instantly we wouldn't be able to afford the lifestyle that we'd been accustomed to. So immediately we began to sort out the truth and the facts from the fiction and and eventually the dust settle. And when I finally got to my my specialist, he said to me, well, he said, look, we're going to start you on a protocol of treatment and I would tell you that I'm pretty sure I can get you three to five years. Three to five years, what do you mean by three to five years? He said, well, until you might pass away. And I go, well, OK, well, that, of course, sent a whole nother whirlwind of fear and thought. And my wife and I really began to evaluate. And that's really my key point. It forces us to come to a point where we have to evaluate our lives, establish our priorities. And then I think financially, try to figure out, are we living the lifestyle? Are we living the life that we are going to need to live to facilitate treatments? Going to specialist to have two hours away. What if what if what if I don't get better? What does that mean? Are all our insurances in place or all our benefits? Does my wife know where everything is that we communicated with our kids? So it forces a reevaluation. And, of course, it's evolving because, as you know, myeloma is an individual disease. So what happens for me may not happen for the next person. So but we really put everything on the table and we began to sort out what our benefits were going to cover, whatever our pocket costs were going to be, what we needed to cut back on, what we needed, how we need to change things. And it forced us into that financial evaluation. Now. So fortunately, I began walking down the road of treatment and I was headed towards a stem cell transplant. All my doctors told me, my local doctor, my specialist said, this is where you're headed and if things keep going right, we'll expect the transplant maybe this coming July or August. So I went through essentially five cycles of treatment in the in the process, by the way, I should step back a little bit. The minute I found out, I called a friend of mine who was in the health insurance business and I said, look, listen to what just happened. And he told me exactly what I needed to do with my health insurance. So I had been on a health care Medicare Advantage plan. I was intending to stay working initially, at least semi-retired and partially working. And now all of that was changing. And I got off of Medicare Advantage, got on to Medicare with a supplement. And of course, for some of you, this is an enrollment, open enrollment period. So if that's something you're considering, I would encourage you to stop and really put some energy into reevaluating your baseline coverage and understanding what's going to be paid for and how it's going to be paid for. Don't be afraid to ask. Call your providers. Call us if we can be helpful as my Loma financial coaches. And we began to understand what the true out of pocket costs were going to be. And fortunately, my wife didn't have to sell her horse that she thought she was going to have to. We weren't going to have to move. I wasn't needing to think about. Stopping work altogether, maybe, but I wasn't sure. But in my case, I got to that point where I was getting ready for stem cell and I had the three day assessment in July after five cycles of RVD treatment. And my specialist said to me, Johnny said, we cannot find any my Loma cells in your body. Well, OK, well, I I've gone from being healthy to being scared out of my mind, to reevaluating everything. And now you tell me I don't have cancer. Well, the fact is, as we know that, as my specialist said, you're so fortunate, but it will probably come back. But we don't know if it's next week and we don't know if it's 20 years from now. So what does one do? I. Talk to my doctors, I talk to my specialist and I personally decided not to go forward with the stem cell transplant at that time, which was supported by my doctors. And I went on to a maintenance program of. Reverend Menendell, Kate and now in Laro, and I'm still on that that maintenance program and everything looks really good. But it did force me to think again. Well, what are my priorities when you're looking at death in the eye? Everything changes and I really came clear that my priorities were not working, if I could avoid it and to try to live my life with maximum attention with my family, my best friends and looking at my bucket list and seeing if I could check off any of those things. So again, it was another reevaluation. And eventually I started volunteering. I actually made a little chart and I said, what am I concerned about? Well, I'm concerned about my health. I'm concerned about living a life of fulfillment. I am concerned about being with my family and being with my friends. And so I began plotting out what I needed to do to do to to achieve all those things in those four quadrants. And I began volunteering with my Loma crowd. I and eventually I became a financial coach. And I still felt great. I felt a little guilty that I did feel so good because I was talking with many people around the country that weren't doing so well. But and eventually I decided, you know, I think one of the things that I'm not fulfilling is I really feel a need to have a purpose and and feel relevant. So I decided to go back to work in my own style. I wasn't going to go back to work the way I did when I was 40. I was going to work the way I am today. And by the way, if I haven't said this, I'm I'm 71. So it was going to be a different world. So I began looking for work opportunities that might tickle my fancy. And I tried things that were way out of my box. But I came back to what I kind of love, which is my financial planning. And I found a firm that I really enjoyed. And they were really telling me that I can work the way I want to work, put in my effort the way I want to do it. And that's OK with them. They understand I'm not 30 or 40 years old anymore. So I found a work responsibility that fulfills me and I can manage it in my time frame and at my speed. So that was important. So let me ask you, John, because you were you were basically a full retirement age. When you end up with my alone. So you had spent a lot of your years assessing as a as an advisor yourself, assessing your financial needs, doing budgeting and things like that. So how can you at for people who are diagnosed close to retirement and retirement and they're looking at their life, not from a perspective of financial advisor, whether say what to do along the way. How how do we guide them? How do they look at their financial picture? To to to present for put themselves in the best financial security position they can they can. That's a very good question. We have under the resource tabs on the health tree, my Loma website, we have some resources, one of which is a a budget or a cash flow form. You can find them online. You can find them other places. We can get one to you if you'd like. And I think that's where it really starts. You really need to understand what is my cash flow, what are my cash flow needs? I've worked with many people over the years who in their retirement years had no idea they they what their needs were, their cash flow needs were. They were just living their life. And some of those people, unfortunately, even healthy people, ended up running out of money for a variety of different reasons. And so I would encourage anyone, whether you have my Loma or not, to sit down and really start mapping out what your expenses are, what your utility costs are, what your grocery costs are. And it's very tedious work. Very few people really like to do it. And then match that up against your income. So if you're if your spouses are working if you're working part time, what if you're not working? What does that look like if you're getting up, if you're on Social Security, if you have retirement income? You know, try to figure that out. And match that up so you have a clear idea that maybe we've got some wiggle room here. Maybe I don't have to work full time anymore. Maybe I could work 20 hours and still address my health concerns, my energy concerns and still have enough money coming in the door. I think that's that's step one. So how do you how do you go about prioritizing your financial life? Because a lot of us, we prioritize what we're doing during the week, what we're going to do at work with our to do list. How do you prioritize your financial lives? That's a good question. I think it it takes some. Some thought, some thoughtfulness. If you have a partner talking with your partner, because sometimes your priorities may not jive necessarily. My number one priority may be my partner's last priority. Try to come to some consensus about what direction do we need to head? The other thing, of course, is what does this new health dilemma pose for me? Am I am I tired? Do I need to make time for a nap? Do I want to reduce stress in my life? How do I do that? Do we have a big house now that I just assume we could handle? Maybe we need to downsize and think about freeing up some equity to be available if we have larger medical needs. I think being prepared, you know, I my kids always used to ask me what I did for a living when they were little. And I'd say I talk about the three pigs all day. And I said, what do you mean? I said, well, you want a straw house, a stick house or a brick house. And because you don't know how things are going to turn, you really want to be prepared for whatever rather than forcing yourself into chaos and fear and anxiety because your health takes the wrong turn and you're not prepared for it. So you sort of have to prepare for the worst and hope for the best. Exactly. And I told I described that exactly to my clients as well. And one of the things we do is we have a lot of people and one of the things you mentioned earlier was a budget. I think a budget is your foundation for your financial life, because if you don't have a budget, you're spending money and you have no idea where it's going. And that money could be perhaps put to better use for health care or premiums and things like that. So but I've also found that a lot of people are afraid of budgets. They think all of a sudden, I'm not going to be able to do anything. I'm never going to be able to go out to eat because I'm strict. And there are people that realize there's hundreds of different types of budgets that fit in with your personality, with your lifestyle that they can take advantage of. And you did mention that we have some resources on our financial page and one of the we have a budget sheet on there as well. I encourage everybody to go in there and look at that. So how does a lifestyle, how does your lifestyle both now your lifestyle is different when you had children and you were saving money for your lifestyle. So how does changing your lifestyle affect your finances both now? And if you're looking down the road, because at first you said three to five years, all of a sudden, your lifestyle is, you know, pretty much curtailed. Right. But now you're looking further down the road, much further down the road. And you have a spouse, your children probably grown. So how do you how do you define that lifestyle? Well, that's that's a very good question as well, because maybe that lifestyle needs to change. I find sometimes some patients, they want to hang on to whatever they've been because they can feel normal. And now they have this new reality that they may not have consulted. And and it may necessitate a change and sometimes change is hard. I'll give you one quick example of a of a patient that I was coaching. And he ended up actually, he was a young 41 year old doctor who was an oncological radiologist or radiological oncologist. I'm not sure which one. But he was diagnosed with myeloma. And what he did for a living was he read myeloma slides all day. Now, I first met him through his wife, who was became his caregiver. And she was panicked when I first talked to her. She was crying and sobbing. And oh, my God, we have our first baby. We just had our first infant. My husband just got named as head of the department at a new hospital. And what is this going to mean for us? I mean, she was just beside herself. Well, I later talked to him and I was saying to him that I said, tell me what your day is like. And he said, well, I pretty much put in 12 hour days and I'm the head of the department. And I'm up at six and I'm not home until six. And I said, that must be very stressful. And he said, yeah, it really is. And I said, you know, looking at myeloma, I personally have come to the conclusion that stress is a negative force to your body and your mind to be able to free your body up and your mind up, to put all its energy into healing. Stress can really be a negative factor. And he agreed. And I said, so what would you do to reduce your stress? And he said, well, I don't see how I could do anything. I said, well, I know your wife's very concerned. I'm sure not being there for her is stressful. You have a new baby. I said, tell me about your being the head of the department. I said, would that be a big financial loss if you stop doing that? And he said, he said, no, he said, they don't pay me anything for that. And I said, so you're spending how many hours a day extra? He said, well, at least four hours extra in my day. I said, well, what if you stopped your managerial duties and just focused on being a clinician and saved the four hours and spend it with your wife and child? And there was silence on the other side of the phone. He said, you know, I never thought about that. He said, I could do that. And I think my life would be so much more fulfilled. I would just be disappointed, but we could do it financially. And I think that's a really good idea. So there's an example of somebody who thought in his mind, there's no way I can get off this treadmill. I'm young, I'm building my career. I have to save money for my daughter's education, blah, blah, blah. But in reality, I could take some things off my plate, still feel fulfilled, still be working on my career, but spend more time reducing stress with my family. And that to me was a very poignant moment. It was, I think, for him as well. So sometimes it's not always financial, but sometimes it's how do you optimize your energy so that you can direct it towards your health? And I think with that is being honest with yourself and being honest with your family. And when you do a budget, being honest with your budget, don't hide things. Don't not include things that are going to be very, very important, because the sooner you do that, the less you have to worry about the money. You already anticipated. And again, John and I will tell everyone the benefit of working with a professional who knows about money, who knows about how to how to access funds, how to to minimize your tax liabilities, how to. You know, there are a lot of things you could do, even accessing funds prior to retirement that you can do if that's an option. There are a lot of things out there I don't think people are aware of. And they're afraid. I think the financial advisors are people who have a lot of money. In fact, I would argue the opposite. A financial advisor is really, really important for those people who may not have a lot of money, because what they're going to do is maximize your ability to use that money wisely. It's true. And I would tell you that we're fortunate because I am a planner. I have software systems available to me. And my wife worked with me for many years. So she actually knows our our financial world much better and in much greater detail than I do. And she manages it totally on the computer. She sets our budget. She knows when we're over budget. And I'm very grateful to having that that being attended to because I'm busy attending to other things. So when I take my myeloma nap in the afternoon, my wife usually on the computer doing something regarding our finances. It's actually quite freeing. It actually can be quite freeing. Yes. Yes. Oh, so that kind of options with someone who has been diagnosed with myeloma smoldering and they're worried, right? They're at the prime of their life. They've already thought about retirement and now they're smoldering. How do you manage both sides of that coin? Continuing to live and then not pulling back too much where now you're just you're just stressed. You know what I'm saying? I mean, how do you manage both sides of that coin? Well, that's really, again, very good dimension of important dimension of of managing a chronic illness. Number one, I would tell you what was helpful for me was being close to other people who were managing their chronic illness. And that came through my myeloma support group. And it came to me through the myeloma crowd or the health tree organization, because I've met some phenomenal people, many of whom are are dealing with much greater health issues than I am. But they have have found a balance in their life. And they have they have listened, learned and taken an attitude of I'm going to get the best of what I'm given. I'm not going to. And my doctor said the same thing. One doctor said to me, she said, John, I think part of your success is your attitude, she said, because I see many, many, many cancer patients and and and many of them really sink back into a bitter, sometimes angry space of denial. And I just wish I could shake them and help them realize that they need to kind of look for the good, look for what's good in their day, looks for what's good in their life and try to find the balance for themselves. It's not easy and it's not fun. But by doing that, it helped me treasure every day and and try to look at at the positive that I can find. And there usually is something there. I was listening to an interview the other day with a famous rock star who was diagnosed with terminal cancer. And he was on a late night show. And the host asked him, how has this made you look at your life differently? And he said, I relish every sandwich I get to eat. And I thought that was kind of funny because I know exactly what he means. I I just love the idea that I can have a great meal. And I'm so so that's a little thing. But I know other people find it in different ways, whether it's their children or grandchildren or travel or whatever. Don't say no, say yes. Right. And I think that balance will come to you, you know, in time. Now, we talk about resources and generally we're referring to financial resources through nonprofits or through pharmaceutical companies. But I would challenge you to to change your perspective on resources. I think the most important resource, as John mentioned a while ago, is other people. Other other patients or other caregivers who are going through the same thing you're going through, because they have a wealth of knowledge. They're coming from different backgrounds. They have a wealth of knowledge and access to other financial resources they can tell you about and how how they're going through treatment. I think it helps me. My husband was one of those people who was very laid back. And, you know, that day we found out the cancer diagnosis. All of a sudden, he was dealing with the big C word. And I'm thinking, oh, my God, our family, how is this going to change everything? And he said, you know what, I'm just going to let you be the worrier. And I am not going to take it on. And he let me do it. And it got to the point where I had to back off, too, because it wasn't good for either one of us. But sitting down, talking about finances is something as a financial advisor, my husband, I had done. And it is very surprising. You may think you're on the same page financially. Your goals and outlooks and things out what makes money important to you. We thought we were on the same page, but when we actually sat down, it was realistic and honest with what we thought was important. Our we could not have been further apart from how we looked at everything. So it's very important when you have something that's going to be very. Long like your chronic illness, and it's going to be very expensive. Now is the time as soon as possible to sit down and start working those things out. Everybody is going to be better off for it, because it's not just that cancer patient who's suffering from cancer. It is the family. And sometimes they take on more of the worry and more of the thing than maybe the cancer patient is with the outside things. Those extraneous things that usually is not, you know, you know, it's interesting. Mike, one of the first things my wife did after Biden diagnosis was she surprised me with a very expensive puppy. And I went and she said, you've always talked about wanting this kind of dog and here's your therapy dog. And he was. And I have to tell you, because I was diagnosed right before COVID. And then we had COVID, which we all were, you know, locked inside. But I swear, if it wasn't for my two dogs making me laugh and making me go outside with them and playing ball, whatever it is, I would have had a very different experience. And I never would have done that for myself. But my wife thought it would be really helpful. So, you know, it could be something as silly as that, but it's important. Now, Diana, I know that you had some significant challenges in your life as well. And you, unlike myself, my children were grown and you had some challenges that you had to face that were quite significant. How did you do that? Very interesting. My husband was diagnosed at age 51, relatively young, but I was 10 years younger than my husband. And so the whole financial dynamic was completely different. I was. I was. Really starting in my field within the financial financial industry, my husband had been working for a long time and was already thinking about retiring in four years, he was planning to retire at 55. And he was a saver. I mean, he had planned for our kids college before I even knew him. You know, he'd already set aside money for college, for private schools and things like that. And and then once you hear cancer, all of a sudden, you know, your goals and perspectives change. Now. I spent stayed home with my kids until they went to school, so that was non earning years for me. And that's very significant after my husband retired. He had a pension. He eventually ended up with social security disability and then using it, getting into his retirement plans. And I was saving. But then I had to stop working. I had to stop work early to start this, just take care of him. So then I was not able to save. During those years. And then when he went on social security and he eventually passed in 2013, I'm thinking, oh, now I'm shouldering for the first time, except for when in college, we really don't have any money. I am shouldering the big responsibility of my kids lives, everything that we all the debt that we have and going moving forward with that. And surprisingly, here's something. It's not surprising. Here's something that a lot of people do. And when you're talking to spouses, this is very important to get under hand early. A lot of times it is the person who's the breadwinner, the biggest breadwinner in the family when they end up with this this diagnosis, then all of a sudden their perspective on money changes, too. They may have been the savers, but all of a sudden they're going to now do things that they they don't think they're going to have a chance to do. My husband surprised me with remember, I was saying earlier that his goals and my goals were completely different. He surprised me by saying, you know what? Always went to boat, so I'm going to go get a boat. OK. And I'm thinking he loves fishing, a fishing boat. No, he would not got a yacht, a 42 foot, 46 foot yacht. And I'm thinking, oh, my God, there's money that is not a money making thing. That is, I mean, sucking dry that will do it. And it did. And he but he had this best time. On that yacht for, you know, 12 years, which was the only redeeming grace of that yacht. I have never been so glad to sell anything in all my life. I walked away from that, didn't remember looking back, saying goodbye to it. I was so glad to get under that. So there's another perspective. When you end up with an illness like that, a lot of people have a tendency to want to spend spend spend. You can't. You need to really look at everything and be realistic about what's going on. And if you were always a spender, now you need to become a saver and be really aware of what your money is doing, how your money is working and where it is going. So that was important to me. Did I answer your question or did I get off on a tangent? No, no, it's good. I, you know, I was thinking about that. In my practice, I would always say to my clients, well, here's a here's a trade questions. When are you going to die? And they say, well, how do I know? I said, OK, well, if we plan to age 90. That's great. But what if you live to 92? Those last two years are really terrible. So I'd always say, let's plan to 100. And they'd say, oh, I'm never going to live to 100. I said, well, you know what? I don't. How do you know? You may. And we may as myeloma patients. I know active myeloma patients who are 20 years past diagnosis and they're still going strong. So we just don't know. And with all the great advances that we're seeing in the field of medicine and treatments for myeloma, I really do believe and I think I've heard this from many of the scientists and the doctors is that we are myeloma is becoming more of a manageable illness, chronic illness rather than a death sentence. So I think all of us should take the attitude that we're in it for the long haul and realize that you don't want to spend everything down to the penny. Too soon. And for a lot of the younger diagnosed people, that becomes more of a challenge with inflation being extremely high now and the cost of everything is just eating up your dollars. And if they had to spend time off from work as well, spouse with the illness or the caregiver, that really does put a strain on your financial lives. And I would encourage them. And I know a lot of people that's speaking with someone yesterday who felt they had a really, really great income, really good income. But I am not going to take advantage of some of those resources that are available to me. That's great. Charity is wonderful. But sometimes it's your advantage to take advantage of those things. If there if there if you were in that. Income bracket where you can take advantage of some of those things, why not, because you know, the cost of health care is going up. Save those dollars, maybe save some money in a bucket for health care dollars instead of spending everything right now, because we know the cost is going to go up. There are so many things that you can do that are fairly easy moves, fairly easy tweaks that I think it puts you further down the road without becoming financially stressed immediately upon diagnosis. Right. And then when I was mentioning earlier, my husband was on Social Security. Now, when he officially passed, I was not Social Security age. So that income, I thought I was going to get as a survivor. It's not there. So I had to make sure I went back to work. Some of the issues may be I need to get some more training to go back to work. There are resources for people out there if they want to get training, go back to work. I think I'd like to add to that. My neighbor is an attorney who was not practicing, but he decided he wanted to go back to work. So he went online and he was looking for jobs that he could put his skills to. He didn't want to be an attorney anymore, but he had skills. He liked documents. He he could read, he could communicate, he could write. And he wanted to work from home. So he called me to just tell me he found this great job working for a law firm, reviewing documents and writing up reports and sending them in all from his home office. So he was thrilled. I was shocked when I went to look back at work, how many opportunities there could be for me to not have to go to the office every day, not have to punch a clock, but to sit at my home and work, you know, through Zoom or whatever it might be. So that's a gift in some ways, because it might force one out of a job that maybe they weren't so happy with anyway and into a new new position that was more fulfilling. Right. I think right now with the COVID people working from home realizing you can be as productive or more productive working from home. And if you have or your if your immune system is compromised, what a better opportunity to explore that than now. You know, there are so many jobs that are out there and they're paying more than maybe what you're you know, we have a tendency to be comfortable, even though we're miserable at our jobs. This is a great opportunity to step out outside the box. Life skills are invaluable. We talk about emotional intelligence. You know, if you've been out working in all kinds of situations, you have some of that emotional intelligence some younger people don't have. And that is that is a soft skill that employers are looking for. Take advantage of this opportunity. Now, I know there are resources out there, as you've said, you know, for example, travel resources. So I travel two and a half hours over and back in a day to see my specialist. I know people that travel more than that. I talked to a recent coachee of mine here. She's traveling to from Tampa to MD Anderson in Texas for her stem cell transplant. And she's going to live in her RV in the parking lot of the hospital. And I said, well, first of all, there are some closer facilities you might want to consider, but she's got it made up. But I said, you know, you might be able to get some financial reimbursement for that trip. And she said, oh, I never thought of that. So there are interesting resources. And Diana, you and I both know a coach that has seems to be a master of getting taking advantage of all the little treats that are out there. As an example, he got 50 yard line tickets to the Super Bowl one year because they had put a certain number of tickets aside for people with illness or disability. And he qualified. And that never would have occurred to me, but it would have. It would have been a fun thing to do, improve my attitude. And that would include things like reducing the cost of your student loans. A lot of people carry student loans into retirement. Those things seem like they never go away, but he's been able to maneuver that because of the myeloma diagnosis he has. So there's a lot of things out there. You get on our resource page. If you listen to our webinars, if you read our articles, there are so many resources out there that are available to you. And so for those people who have young children, there are resources for people with cancer where they can get child care for travel. You can get American Cancer Society will help with room and board if you're getting treatment outside of the outside of your local area. And they'll put you up at really nice places. We've stayed at the West End in Chicago on on on the magnificent mile. I mean, there are some things that they can do that really, really help you. And I encourage everyone to take advantage of those things. Now, we're talking about the cost of health care is extremely high and it's going up and medications, the cost of medications are growing up. I would encourage everyone to to look at our page that talks about especially relevant, we know. And we had that little in a mind that is the generic. Well, that generic is only a few thousand dollars less than the the revelment in addition to that. And I find that a lot of doctors are are putting people on that that generic. But it's hard to find. It's not it's not completely out. Right. So it's becoming one of those things that's very difficult to find. And some insurance companies are actually telling their insurers that they have to get that generic. But they're having a hard time finding it. So whenever you're looking at your finances, look at your health care now and what your plan to have done next year. And if you're changing, if you're changing treatments and include that in your insurances, now, remember, open enrollment for the exchange is coming up November 1st. So look at do comparison shopping, please. That is going to be your biggest your your main foundation for your health and your health care going forward. John and Diana, can you hear me OK? Yes. OK, perfect. My computer in the other room is doing weird stuff, so I'm glad that I got found a place where it's working. That was an excellent discussion. I think the flow between you two and just the the topics that you guys were able to hit on have been very helpful. I really enjoyed this format that you guys have had. There are several questions, so I wanted to make sure we tackle those. One of the questions that I see here is, is there any way to find out the odd out of pocket costs of your entire lifetime of treatment? I mean, no, unfortunately, right? What treatment you're going to be on and for for how long? Let's talk about change. Yeah, totally. Let's talk about, for example, if you're if you're newly diagnosed and your multiple myelin specialist was to prescribe you RVD, Revlimid, Velcade, Dexamethasone. How would you know how much your insurer is going to cover and how much you would pay out of pocket? The first thing is to get your insurance policy and then call. Yes. John, you can add. Well, that was the thing. That was exactly what I was going to say. You need to understand what your benefits actually cover and how these different companies treat the specific drugs that you've been prescribed. RVD is fairly common. By the way, the V, the Velcade part is actually not a pharmaceutical. It's treated under part B of Medicare. So when I first started, my first claim was kicked back. And it was, I don't know, five thousand dollars. I don't know what it was. And I freaked out. And then I called the finance office of my practice. And I said, what is this? I thought this was going to be covered. And they said, oops, we're sorry. We filed it incorrectly and will refile it under part B as opposed to pharmaceutical. And that was in the doctor's office that administers the medicine. So pay attention, you know, understand things so you can see that if there's something that's out of whack, you know how to ask a question and ask ahead of time when you first start diagnosis or you're starting treatment, find out what medications are going to be involved. And it's not just those primary medications. You may end up with other things as well. You may need to do PIP supplements. You may need to do diabetes supplements. And those things are costly as well. Find out what this treatment is going to cost you. And look at your insurance. Your insurance will change, can change what they're going to cover every year, especially Medicare. Those things change a lot. There's a lot. There's a lot of changes coming up. January 1st. So, John, let's talk a little bit more about this Medicare. Rex was wondering if you could go into more detail about Medicare with supplements and how that has helped pay for your chronic illness versus the Medicare senior advantage, which is what lots of our patients have. Yes. And Diana knows a lot about this as well. I just know that when I first became 65 and I left my corporate benefit plan, I decided to go towards Medicare and I was healthy. I was 65 years old and healthy. I had very few medical problems. And the agent I talked to said, well, everybody in Vermont buys this plan, which was the Medicare Advantage plan. So that's what I did. And it was fine until I got diagnosed. And then I called my friend who was in the business and he said, get off that plan immediately and get on to a regular Medicare plan. Now, what we know and you're seeing, I'm seeing it online much more this year than before. There is a difference between Medicare Advantage and Medicare. And it goes back to the old adage, if something is free, it probably isn't. So here's the issue that I see trying to sum it up very quickly. If you're not paying a premium for something such as Medicare Advantage, you're going to pay some way else, probably with out of pocket costs. And you have to be very aware of that. Whereas Medicare, you are already paying a premium. You're going to pay for a supplement on top of that. And you're going to buy, you know, a la carte pharmaceutical plan, etc., etc. Feels like a lot of money, but. Not knowing how your illness is going to evolve, you can be assured that no matter what happens, you don't have to ask to go see another specialist. Your copains are going to be covered. You can go to see any doctor anywhere. And in myeloma, you know, we've all met myeloma patients. One fellow was from Nashville and he went to Arkansas because he found a doctor there that he wanted to see. And then that doctor moved to New York. So he went up to Sloan Kettering to be with that doctor. And he never had to worry about it. Now, I know things have improved. Some of my friends who are on Medicare Advantage say they haven't had a problem. And I think of that as being kind of lucky because they really don't know why they didn't have a problem. And there may come a time in their health history where they're going to wish they had better coverage. And it's it's it's if you're working with a broker, I would think that broker could help you figure out what your worst case scenario might be. Right. Exactly. And that's what I was going to add here is this is something that would be great if you wanted to connect with one of our myeloma financial coaches to talk it out with them and then they could recommend you to, hey, I really think you're going to need more professional help here. Here's my recommendations of who you could see. I mean, it's so helpful to be able to say, OK, talk to me more about what you think about this or I'm thinking this. What do you think? And getting this professional help. And then they are well trained to know, like when it's time for them to stop giving free advice and you to start getting more personalized advice that you would pay for. So excellent answer. I think I have one other thought on that. And that is to realize that you and your spouse, if you have a partner in that way, may be on different coverages. You don't both have to be on exactly the same coverage. So my wife is very healthy. She has never goes to the doctor. She's gone to make sure that there's nothing really coming. And we've decided that for her, she might be better off going to a more high deductible plan. And if she gets ill, we still know that we'll never pay more than we would have if we paid a higher premium. But that's not what I'm going to do. I'm going to do something different or I do something. Great point. Great point. Thank you. Shelly's wondering, what about a life insurance that has a living benefit and Diana, I'll get this one. Well, actually, either either one of you could answer that. If you don't mind, I live. Yeah. In fact, yeah, I was talking to a client about their living benefit. So life insurance typically today and actually for several years, many companies, the better companies have been offering riders, some of which have no cost, some of which do have costs. And they're typically called either an accelerated benefit rider or a living needs benefit or a benefit rider. And they what the company can do is if you are diagnosed with a chronic illness, typically that's going to be terminal in nature or with some policies, even if you need long term care services, the company will advance the tax to cash to you at no cost, no questions. Well, you have to qualify. But and it's an advancement of the actual death benefit. So if you are in a terminal illness situation and you expect that you will probably pass away within the year, but your expenses for care over that year are going to be very, very high. Take some of that money from the life insurance policy. It just means that your death benefit at your death will be less by the amount that you were advanced earlier. And then you're going to go ahead. I was just going to say, but then your family's less left with less medical that and less problems when it comes to that. Exactly. So I think it's a great benefit. I think it's available in today's world with most term or permanent coverage is actually. The other thing I should mention, since we're talking about it, is if you are a patient and you have term insurance, realize that that term insurance is going to get expensive one day. And you might want to look into options of converting that term insurance. And when you do that, you could put on a critical illness benefit. If you didn't have it already. And if you have if you have the opportunity, especially coming up in the time, this is open enrollment period for a lot of people. Or you may have a life extinguishing circumstance during the year where you can go back and change your benefits. If you do not qualify for life insurance now and you're still working, this is a great time to pick up that life insurance at work. And some of those insurances can be can go with you, which means you don't you don't qualify for underwriting. Don't you do blood or urine? You don't have to say you have myeloma. You can go on and you can get qualified for insurance. And a lot of those policies are you can move with you. And if you want to convert it to your own policy, you don't have to do underwriting again, as long as you're not increasing the death benefit on that writer. Thank you. Two more questions here. And there was also a comment about how nurse navigators can really help find these kind of resources. So to remember to use them on your team as part of this searching for financial resources. So great point. One of the final questions says, does your financial planner have to be familiar with medical costs? They really should be. A double yes. Yes, you don't want a painter who paint cars to paint your house. You know, it's basically the same thing. You want somebody who's familiar with because it's not it's not easy. It is very intricate. There's a lot of moving parts when you come to health care. And so that person needs to be aware of the health care system, how it works. They need to understand billing. They need to understand insurances. Yes, they need to understand that. Yeah, I think that the studies show that the greatest surprise of most retirees is how much they have to spend on health care costs. And I think that in the literature that I read, I think it's underappreciated. I think it's I think people need to have more money available than less. Exactly. I agree. And then everything. Definitely. Thank you. And then the last one, maybe if we can get some clarification here, Phyllis has been told that she cannot get into a Medigap plan because she has multiple myeloma and must stay on her Advantage plan. A lot of times, if you did not get into a Medigap supplement plan at your initial enrollment period and you already have these disease, they can decline you. You have guaranteed issue from your initial enrollment period. That is the best time to get a Medicare Medigap plan. Because later, if you wait a year or so, they can decline you. Interesting. Yes, the other thing I should say is I'm in Florida and every state is different and there may be different companies available. And when I my friend said, get off that advantage plan, get onto a supplement plan, there were eight companies available and only one company would take me. Luckily, and they did. And that was mutual. So I'm not a plug up. I do want you to know that I was a little shocked that they did and they've been great. Interesting. OK, well, thank you both so much. Are there any other closing statements, Diana, that I'll have you go first and then John, that you would like to make before we finish today? Again, I would encourage everyone, first of all, to do your budget. Just sit down with a professional. And a lot of times they will meet with you the first time without any costs at all and start getting some guidance. You can reach out to us as a financial coaches to help steer you, get you started. And and don't be surprised at the cost. Generally, as a financial advisor, can give you returns of one to four percent of what you do on your own. In addition, give you some invaluable advice that you're not going to because that's their professionals. That's what they do. John. Well, I would agree with that. And I'm not treating my own horn here, but I I met with an 83 year old fellow the other day who's become a client. And his previous advisor really was a life insurance agent. And I'm sure he's a very good life insurance agent. But I'm a planner and I take a more holistic view. And I understand all the things you've been talking about tonight or today. He said to me, I've learned more from you in 20 minutes and I've learned in 20 years of that other guy. And and that's not to my horn. That's just because I have different training and I have a different approach. And I think just as you might look for a second opinion in medicine, you might look for second opinions in your financial assistance as well. Exactly planners. And we understand the importance of planning life financial planning. Yeah, great input. Thank you both so much. Thank you all for attending today, for taking the time out of your day. Just a reminder to fill out that follow up survey that was doing will prompt you to take as you leave the meeting. Join us next year. Oh, my gosh. So exciting to say, can't believe it's November already. We're going to take a hiatus in December so that we can all get some rest. But in January on the third, we're going to welcome in the new year with the topic preparing your tax filing for 2022. And and then you may be interested in other community events. Tomorrow, we have the healthy moves chapter. We're going to be having a yoga class where we talk about the benefits of myeloma, we do yoga together. It's going to be awesome. And that's led by myeloma patient, Jean Becker. And then we're going on the third. We're going virtually we're going into the southeast part of the United States, where we will have our discussion, building your health care team together. And that's all the way from Delaware to Georgia. So quite a big range. If you find yourself within that region, please join us. And then November the 8th is our stem cell transplant chapter. We're going to be reviewing a little known, incredible resource that is existing on our website, which is the complete guide to stem cell transplant. So we want to highlight that resource, show you where you can find it and show you where you can share it with others. So the link to sign up for any of those events and even more events I haven't mentioned is found at the bottom of the slide and will be included in our follow up email. Another big thing that we want to share with you is that we have a new website, which is the best way to get started. So you can find the link there. And then we're going to have our discussion. So that's all the way from Delaware to Georgia. So thank you so much for joining us. I hope you enjoyed this webinar, and I want to say a big thank you to our sponsors, Bristol Myers Squibb, GSK, Genentech, Abbe and Amgen. And again, thank you to each of you for helping us build this community. We appreciate you. Hope you have a great rest of your day. Thank you, John. And thank you, Diana. Excellent job, you guys. Bye bye. Take care.