Financial Matters

Planning with Clarity and Compassion

Your loved one may be reluctant to let you help with finances. By the time they agree, things may be misplaced, misunderstood, or even compromised by scams or cognitive decline. Still, as caregivers, we must step into this space—with sensitivity and firmness—to ensure both care and financial health are preserved over time.

The First Step: Accept the Reality and Plan Ahead

You may not want to “get into their finances.” But doing so is an act of protection—not control. Whether your loved one is facing the slow progression of aging or a degenerative disease, financial planning is critical to ensure:

• Their care needs are met
• Their assets are protected
• You, the caregiver, do not suffer long-term financial harm

It begins with asking the right questions:

• What type of in-home care or facility-based care will be needed?
• Who will provide it—family, professionals, or both?
• When and where might assisted living or memory care be required?
• How long can we sustain care with current resources?

Create a Working Budget

Build a care budget that includes:

• Monthly living expenses (in-home or in a facility)
• Medical care and prescriptions
• Professional caregiving services
• Travel costs (especially for international caregiving)
• Insurance premiums or supplemental plans
• Unexpected/emergency expenses

Then, gather details on funding sources:

• Social Security or pensions
• Retirement savings, IRAs, 401(k)s
• Long-term care insurance, if applicable
• Health coverage: Medicare, Medicaid, private insurance, expat health plans
• Home equity or sale proceeds from property
• Support from family or financial assistance programs

Bring in a financial advisor or trusted support person for perspective. You don’t need to do this alone.

Caregiver Sustainability: Protecting Your Own Financial Future

Too often, caregivers exhaust their own savings to provide care—selling assets, leaving jobs, or burning through retirement funds. This is noble, but also dangerous.

Ask yourself:

Is it sustainable to deplete my own net worth to pay for care?

You deserve a future, too. There must be balance. This is where your support network can help you stay objective and committed to a long-term, viable plan.

1.           Overview of Healthcare & Funding Options: U.S., Canada, and Mexico

Understanding how care is funded across countries is critical—especially when considering assisted living or memory care in Mexico.

1. U.S. Medicare

• Does not cover long-term assisted living or memory care
• Covers some medical care, such as skilled nursing, rehab, or home health under specific conditions
• Medicare generally does not cover care received abroad

2. U.S. Medicaid

• May cover some assisted living costs if your loved one has low income and qualifies
• Programs and rules vary widely by state

3. U.S. Private Payer & Long-Term Care Insurance

• Families often pay out-of-pocket, using retirement funds or home sale proceeds
• Long-term care insurance may cover some expenses, depending on policy terms

4. Facility-Specific Funding Plans

• Some U.S. and Mexican facilities offer private installment plans or in-house care cost-sharing, especially in smaller, family-run centers

5. Expatriate Health Insurance

• Designed for those living abroad (e.g., Cigna Global, AXA)
• Many exclude pre-existing conditions or age out at 74
• Some plans are country-specific and lower cost if limited to your home country and Mexico
• Cigna and AXA are known for covering any age, with flexible options

6. Canada’s Single-Payer System

• Provides a mix of publicly funded home care, supportive housing, and long-term care
• Costs are often shared between the government and individual, based on income and assets
• Private-pay communities are also available, many offering continuity of care (similar to CCRCs)

7. Canada’s Private-Payer Options

• Continuum-style communities allow seniors to age in place, transitioning from independent living to assisted or memory care as needed

8. Mexican Public Healthcare (IMSS)

Three tiers of care:

1. Seguro Popular – Limited, for unemployed or rural Mexicans
2. IMSS (Instituto Mexicano de Seguro Social) – Available to employees and retirees with a Residente Permanente visa
3. Public Hospitals – Subsidized, but variable in quality

Important for expat caregivers:

• IMSS is not available to patients on a Humanitarian Visa
• Care is only available via IMSS doctors and prescriptions—you can’t substitute outside care

9. Mexican Private Healthcare

• High-quality and affordable, often with U.S.- or Europe-trained physicians
• Most expats use private hospitals for consistency and service
• Many private facilities do not accept foreign insurance, requiring cash up front
• You can file for reimbursement with your international insurer after discharge

10. Prescriptions in Mexico

• Pharmacies are plentiful and affordable
• Some U.S. caregivers choose to bring medications from the U.S.—though this can be risky due to:
  
  • Prescription changes
  • Insurance issues
  • Import regulations

Some advanced care facilities in Mexico maintain relationships with pharmacies, stocking commonly used drugs to ensure availability and affordability.

2.           Final Thoughts: Financial Clarity Supports Emotional Stability

You may be navigating two countries, two currencies, and two sets of healthcare rules—all while trying to protect the dignity and well-being of someone you love. It’s a monumental task.

But with a clear plan, trusted advice, and a heart-centered approach, you can do this. You can care for your loved one and protect your own future.