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4 Steps to Help Prepare for Health Care Expenses in Retirement

Explore key considerations to manage rising health care costs in your retirement planning.

by Michael W. Brough - February 04, 2019

No two people spend the same amount on health care costs in retirement, which is exactly why developing your own approach for this expense is a key part of an effective retirement planning process.

According to Will Larson, Retirement Planning Strategist for Wells Fargo Advisors, knowing your expected health care costs and coverage options gives you a better chance for meeting those obligations throughout your retirement—so you can stay focused on the excitement of what comes next.

Here, Larson offers strategies for deciphering health care expenses in retirement.

Estimate your costs

Estimate your costs.

Numbers vary widely (one recent study found that those at age 70 can expect to spend roughly $122,000 on health care through the end of their lives, although some can expect to spend nearly five times that amount). Larson points out that the right number for healthy, active people can sometimes be counterintuitive. “For example, your health care costs in retirement can be greater if you’re healthier,” he says, “since you get treatment over a longer lifespan.”

A financial advisor may be able to get you a more accurate estimate with a healthcare costs assessment that analyzes expected Medicare-covered costs, out-of-pocket costs, and other expenses. There are also simple health care cost calculators, such as this one from AARP.

Determine your expected health care benefits

Determine your expected health care benefits.

Few employers continue benefits into retirement, so you will need to explore your coverage options if you aren’t yet 65 and eligible for Medicare. (Employment trends like the increasing prevalence of freelance and contract work, and the overall rise in the gig economy, may mean that you’re self-insured and already have insight into that expense.)

Even if you are eligible, you need to determine what the government will pay. Research your Medicare options online. “Pay attention to the details,” warns Larson. “Medicare might not cover what you expect.”

Some examples:

  • Medicare may pay only a portion of costs for people staying in a rehabilitation center or nursing facility, and there are restrictions on what is covered.
  • Coverage is limited to certain skilled care procedures performed by a registered nurse or doctor, such as intravenous injections and physical therapy. It also doesn’t cover the cost of procedures such as routine dental care and hearing exams.
  • Procedures done to improve your appearance without a medical need are not covered.

Larson also recommends researching your medication coverage. “Before you retire, ask your pharmacy for a Medicare Part D report,” Larson says. “They’ll provide a rundown of what your medications will cost in retirement and how much is covered for the various Part D options.”

Factor in long-term care

Factor in long-term care.

Long-term care involves services people may need if they’re chronically ill or have disabilities rendering them unable to perform activities of daily living such as bathing or dressing. The need to prepare for those services may be more important than you think: According to the U.S. Department of Health and Human Services, more than half of Americans age 65 or older will need long-term care services at some point.

In the case of Medicare, coverage kicks in only if long-term care is medically necessary—and then only for 100 days in a skilled, or specialized, nursing facility following a three-day inpatient hospital stay. The alternative—staying in a semiprivate nursing home—can prove costly. The national median cost of a semiprivate nursing home room is more than $7,000 a month.

Research options to fill the gap

Research options to fill the gap.

Whether or not you qualify for certain coverage under Medicare, you’ll likely need an additional resource to help balance benefits and costs. Those who have Medicare may want to consider a supplemental health insurance policy such as Medigap. It helps you pay for some of the costs Medicare doesn’t cover.

Another option is purchasing a long-term-care insurance policy, which may help you avoid, or at least reduce, the amount you might need to dip into your savings for related costs. The average stay in a long-term-care facility is four years, so if you don’t opt for long-term-care insurance, you may need to set aside roughly $250,000 to $400,000 to pay for it yourself, depending on your required level of care.

The two main forms of long-term-care insurance are traditional and hybrid. The traditional variety typically involves paying an annual premium and lets you choose how much coverage you want.

The hybrid option is a life insurance policy that allows a portion of the cash value of the policy to be used for long-term care. Beneficiaries can also receive a death benefit when you pass away. Death benefits will typically be reduced if long-term care benefits are used.

“Retirement planning is about understanding and mitigating the biggest risks,” Larson explains. Then you can decide how to address the risks so that you’ll feel comfortable about your future.

Michael W. Brough is a Texas-based writer whose work has appeared in the Wall Street Journal, the Washington Post, USA Today, and other outlets.

Images created from iStock

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