Watch: My Mom's Care in the US Cost Me $500,000... Nobody Talks About This | NRI
A interview-based NRI story on hidden elder-care costs in the US, Medicaid vs Medicare confusion, home care, nursing homes, and why bringing parents permanently can become overwhelming.
The full write-up, with the numbers and the links.
Chapters
- 0:00 Introduction
- 1:03 Why move to US and career
- 3:51 Incident that changed everything
- 7:30 Reality of Elder Care in the US
- 10:22 India vs US : The Real Decision
- 12:17 Final advice for NRIs
Transcript
Auto-generated captions, lightly cleaned
0:00 You know, it approximately costed me for a 7 year stay close to half a million just to give her a shower. For each shower, they will charge you $125 then just shower only. So, underlying factor is you should have at least, you know, for each person because I'm a finance person, a minimum of a 1 and 1/2 million dollars. >> This is the side of NRI life nobody talks about. Today, we are going to discuss what happens when your parents get sick in the US. And how much it really costs for the elder care in the United States. >> My name is Suresh Kuduvalli and she obviously is Yoga Kuduvalli. So, we are basically from Mysore in Karnataka and I am by profession I did my Bachelor of Business Management and then ICWAI, which is called as cost accounting. And then I was into manufacturing cost accounting basically.
1:01 The initial, I would say, 6-7 years was
1:04 A super struggle because I was in a back in India, I was already a senior manager and part of the top management. Here, you have to start from scratch, right? They don't care who you are. So, you got to prove your metal and then come up the ranks. That was an adjustment. And on top of that, you know, it was I was not making that kind of money. During those time, I used to make something like 60-70 grand. And for a family of three and my mom also joined me because my mom was a widow. There was nobody else to take care of her. So, she also joined me. It was a real super struggle, I would say. My brother started telling, "Okay, come over to US and then try here, you know, whatever it is." Then, okay, I got my H-1B visa for a manufacturing company called Wings Digital Corporation. That was in Hicksville, New York.
1:50 So, they sponsored me then I came here on the H-1. As a cost accountant for that plant. But then what happened is 2000 it happened and as soon as I came, I don't know you guys in tech can understand that at that time there came a company called Napster. I don't know if you remember that. They flipped the business upside down of the CD manufacturing. Yeah. Because overnight it it moved from hardware CD manufacturing from tape recorders to CDs CD it went to MP3 or whatever that format is you know that all the CD manufacturing started vanishing from United States. So that is all started going to Korea Korea and then China. So the fate was written that the company is going to close down sooner than later.
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2:35 Then I found my value in but I am a cost accountant by profession. I said why not I look into an area either there was again a choice there. Again go back to India or stay and find another job because we had we had already invested here. My son was here in the school and all that is again keep on it's difficult to uproot people, right? So I said no, I need to find a stable industry where you need to have a foothold where you know you can stay longer time. So the only thing that was I I identified was you go to IT then you got to keep on upgrading yourself. That's also kind of very kind of very dynamic. The next industry was pharma industry or the third is finance. The finance is where my strength is, right? So I started focusing on wealth management industry. When I 48 years old I did my CPA exams.
3:28 >> Yeah. >> I passed it you know that was kind of a record. I think in my batch when I passed like very few people were 45 plus you know 48 plus you know I was 48 and I passed that exam then became a CPA. Then I've been in this company since then. Now it's right up to this year December I'm going to retire. The reason why I wrote in the website
3:53 That I need to come back to India is there is a big life lesson that I learned in my life. My mom was I told you was staying with me, right? She had a lot of health issues. Then it so happened in 2015 so she was staying with me she had whatever that known that day like she had and then she went to the toilet and fell down. She had blood pressure, she had diabetes. You know, you name it and she had it cholesterol and all that. And then when she fell down she fell down in such a bad way like she couldn't even open the door because you know, in America the the toilet opens inward right not outward, you know, so she I cannot even because her body was there to push the door. Somehow I got in stabilized her called emergency and all that.
4:38 Then when when the medical emergency comes they kind of separate the husband and wife and ask them what happened. The reason is there is elderly abuse they call it as. You know, that could be there then you know, you will go to jail. So that's there's something that everybody should know. You know, it was luckily we answered the questions in the same way. Even if you deviate a bit then then they will they will flag it. Mhm. To the to whichever the department is then then she was taken from to hospital and then she was hospitalized. Then they they said that she lost the control base down. There was no way. And if you come back home then we said that then our world turned totally upside down in 2015.
5:25 So because of this then finally I found a nursing home which is managed by Indians. Gujarat that was a Jewish nursing home in which one particular floor was taken over by Indians. The Indian community also. And luckily I had got my mom Medicaid. You know, there's a difference between Medicare and Medicaid, right? Medicaid is for low-class income mom did not have any assets because you cannot have more than $3,000 to your name if you want to get Medicaid. And there is a look back period. That means they look back for 10 years and and make sure that she doesn't have so much of money. My mom did not have anything because we were from lower middle-class family in in India. So, she we didn't have any assets. So, we she went to the hospital. She had Medicaid, but the problem is that Medicaid covers only so much.
6:18 >> Mhm. >> Like just to give you an example, the the they give you a shower, right? So, if Medicaid is there, they'll give you a shower only once in 2 weeks. >> So, but if you want the regular care, then you have to pay It's like a la carte. You want to do any services, pay me for that. >> Okay. >> Even clipping the nails, they used to charge. So, then our life kind of so I have a brother who is here, but he has his own problems, you know, like he had his own family's issues. My sister is there in Bangalore, and she had her own family's issues. They could not step up to take care of my mother. So, it fell on my shoulder and her shoulders. And Yogamba, what she did is after my mom moved back, you know, she tried her She was also working at that time.
7:05 So, it's difficult to manage work, taking care of mom full time, like you know, you have to put the diapers on. And you know, American bathrooms are not like Indian bathrooms. It's very difficult here. You have lived here. You know how hard it hard it is. And you cannot even throw the water, like you know, everything has to be done in a proper way. And while all these obligations of elderly care, it was becoming difficult. Then ways down, it was totally unmanageable.
7:32 Example, tomorrow got far better. I and Yogamba, both of us become incapacitated and we had to go to the nursing. Okay, if we go to the nursing home Medicare covers you for only certain months, like 12, 14 months or 12 months or whatever the time limit is. That keeps changing. So, 14 months, let's assume Medicare will kick in and they'll pay. Then after that they'll stop paying. What they will do is they will give you the care but then they will attach your assets. You see what I'm saying? Like they'll come after your assets. And in some states your primary home will be saved. Not to the end. And once everything is done they will complete the whole process and come back and sell the home, they recover their money and give the balance to your kith and kin or whomever you have nominated. Mhm. That is the process. This is one reason why it's very hard if you have not sufficient money in your account to retire in America.
8:33 So, if you have millions of dollars then it's fine. Then what happens to elderly care is the next question, right? And how will you going to manage? >> The best thing is to stay at home and get care within the home. For that you should have taken long-term care insurance. That kicks in. But that again has limitations. Now, you know, they all the long-term care insurance companies started going belly up because people are living longer. >> Longer. >> Not like what it is, right? Their math is not working. So, what do they do? They are putting a lot of limits. So, you can get the care. And just to give you an example, when my mom was at home, we used to get her a care person just to give her a shower. For each shower they will charge you $125 then, just shower only.
9:18 But if you want a care person to be with you then they will come and stay with you and they will they they the going rate is something like $35 an hour for them. To pay plus you know, they're going to be there with you then all the time you cannot have, right? You know, then your math becomes too hard to manage. >> Long-term care insurance is for one person premium per year is $10,000. I'll give you my example. $10,000 per year and you have to pay for 9 years, which is $90,000. Right? And the deal is, if I get into nursing home, right? They adjust it to some cost of living index. And today, for example, tomorrow I get into the nursing home.
10:04 And they will pay for 45 months, every month $5,000. I would take long-term care insurance, especially the moment you are 50. And also remember, the long-term care insurance premium goes up the moment you start crossing 50 years of age. It goes up. The premium. So, you're smart enough when you're able to get it
10:23 At a younger period. You can leave a country, a country will never leave you. You know, that's so what? That's 100% truth, especially from my generation of people. I'm born in 1960, right? So, I lived when I came to United States, I was something like 38. So, you know, you come to United States at the age of 38. You have lived 38 years in India. You know, how can you just let go of that? You know, the thought keeps coming back. When my mother was in nursing home, when we were doing two jobs, and there is one old age NRI ashram, mostly run by Vaishyas. That means there are a lot of merchant community of Telugu who live in Karnataka. So, they are also vegetarians and they are merchant community, they are very rich. The second thing is my mom never wanted us to stay there. I said, "I won't come back. I want to be with you." So, what can you do? You know, I said, "When she came back." It depends. For example, I might have a million dollars, right? Then my mindset is, okay, you know, why do I
11:24 Want to go back to India? Maybe my children are here. I want to stay with them. I don't want to go. I'll somehow pull on here. Somehow, you know, I will exist here. Some people might think, hey look, it's $1.5 million, so then then if I go to India, maybe I can give it to my children. They may not be doing so well. I can bequeath it to them. So that, you know, it becomes good for them and I am anyway okay whether I'm old, whether I live in India or America, doesn't matter. So if I go and live a decent facility where I can, you know, what do I need? I need two square meals and a place to rest, right? So in some engagement, if that is there, why not I go there, you know? My relatives, friends are still there. So it depends, you know, it it is very complex, you know, it >> Yes.
12:10 >> never once said one shirt suits all kind of situation. You know, what do we depends. Even for me, I'm telling you, I and Yogamati keep on debating
12:18 Whether to go or not to go. That discussion will come at least once in a while. If you are living in America on green card or whatever, and if your parents are in India, don't bring them here. Because, to be very frank, taking care of my mother, it approximately theoretically, you know, it approximately costed me for a 7-year stay close to half a million dollars. Okay, over a period of 7 years. All kinds of expenses, you know, that needs to be paid off. God gave me the grace. My wife was there to support me. We paid off. Okay? But not everybody can do it. You know, it's hard. Okay, you can put them on Medicaid. Again, it depends on state. Some states might be able to take. I know, for example, I know somebody was telling me in Phoenix and all that everything is free.
13:07 I don't know that. I'm talking about New Jersey. It's expensive. So be be careful, you know, be thoughtful before you bring them here to permanently stay with you. And nowadays the immigration is also getting on. Now they're increasing. Now when my mom came here, the $3,000 to your name look back period was something like 18 months. Now they have made it 5 years and now they have also linked your passport to Indian Indian passport and American database, I believe it talks because I'm a CPA. I know what they do is they will go they will be able to check your assets in India. >> then they will reject reject all kinds of benefits. It is complex, you know, you don't want to get into the trouble at all.
13:54 >> You somehow make an arrangement, you go and take care of them. Or they come here as long as they can once in a while. Because they are loved ones, right? That's one thing. Number two is if your situation is such that if your children are not doing that great and you want to give pass on your wealth to them, then it's a good idea to move back to India. Because the your if something happens to you, all the money you can still protect and then get let go of your to your children. Instead of that going to government. >> We come here, it will be only one idea we have to do well in our life. >> Right? When we come over from India. But from moving here, it's so many things will be there. We have to look after our kids, our parents, everything. We are the sandwiches in between that.
14:43 >> Thanks a lot you know for taking the time and sharing your story and especially bringing some of these things on the medical side, right? I think you know the experiences you had with your mom and all that stuff. So really appreciate being very open and transparent and sharing that information to us today. >> Thank you. I appreciate it.
