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Plan Now – or Pay Later – for Your Health Costs in Retirement

By Jean C. Setzfand, Vice President of the Financial Security team in the Education and Outreach group at AARP

Jean Setzfand, Vice President, Financial Security, AARP Education & Outreach
Danuta Otfinowski/Danuta Otfinowski

I don’t know about you, but I plan to live a very long (and hopefully healthy) life. My father lived to 82 – even with three separate bouts of cancer – and my mom is still going strong at 76.

So I’d rather bet on living to 100, and plan accordingly, than run the risk of outliving my money. Frankly, I’d rather get hit by a bus than run out of money in my later years.

And if 30 or more of those later years will be spent “in retirement,” it turns out I can’t afford not to be healthy.

I found this out the easy way, by using AARP’s newest online tool, the Health Care Costs Calculator.

The tool, which was produced and sponsored by Optum, is our latest effort to help people identify and plan for costs they will face in retirement. It turns out that health care is a much, much larger expense than I had ever imagined – even for those with supplemental Medicare and retiree health benefits through their employer.

The calculator told me to plan on spending about $311,000 out of my own pocket on health care during my 30-plus years of retirement. Most of the sticker shock comes from the cost of premiums, deductibles and coinsurance requirements. But this new tool also factors in the costs associated with specific diseases that run in my family (hello, cancer), and provides some tips on how to manage those diseases (hello, vegetables!).

Apparently, I’m not alone in my naïveté about retiree health care costs. In a recent AARP study, we found that the vast majority of respondents have never tried to figure out how much their health care will cost them in retirement. And when we asked them to give a ballpark estimate of how much money they might need, most guessed that they would need less than $50,000 to cover their health costs throughout retirement.

Clearly, this new tool fills an all-too-common gap in the retirement-planning process. As you’re planning out when and how to retire, be sure to check out the tool and take stock of your estimated health care costs. (And eat more vegetables!)

In the meantime, here are a few things to keep in mind about retirement health costs:


  • Most of us will qualify for Medicare at age 65, as long as you or your spouse worked and paid into Social Security and Medicare for at least 10 years.
  • While Medicare is an incredibly important safety net, it does not cover all of your health care costs. There are significant out-of-pocket costs such as premiums, deductibles and coinsurance requirements to take into consideration.
  • Medicare is broken into four different parts: Part A (also known as “Original Medicare,” which provides hospital care), Part B (non-hospital medical care), Part C (also known as “Medicare Advantage,” private HMO or PPO plans that combine Parts A, B and D, and may have lower out-of-pocket costs) and Part D (prescription drug coverage).
  • Although most people don’t pay premiums for Part A (because they already paid for it through their payroll taxes), there are deductibles and coinsurance requirements for all four parts, and premiums to pay for Parts B, C and D.
  • When you’re choosing the best Medicare plan for you, the lowest premium may not be the lowest-cost plan overall. Even Part A charges an annual deductible of more than $1,100. And if you do end up hospitalized with just Part A coverage, let’s hope you don’t stay long: After two months in the hospital, you’re expected to pay almost $300 per day out of your own pocket. After three months, you’ll be charged almost $600 per day.
  • Out-of-pocket charges may be lower and more predictable under a Part C Medicare Advantage plan than under Original Medicare. The downside to these Advantage plans is that they usually limit your choice of doctors and hospitals.
  • You should plan to re-evaluate your Medicare coverage needs each year during the open enrollment period, which runs from October 15 to December 7.
  • If you’re under 65 and have a high-deductible insurance plan ($1,250 or more), you might want to consider setting up a health care savings account now. Your contributions are tax-deductible, they’re invested in the market, and they grow tax-free. And if you use the money to pay for medical expenses, you’re not taxed on the withdrawal. Best of all, unlike traditional flexible spending accounts, the money rolls over from year to year, helping you build a health care nest egg for your later years.

Bear in mind that the health care costs calculator doesn’t factor in the cost of long-term care. With any luck, you won’t need it. But again, that’s not something I would gamble on.

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Jean C. Setzfand is vice president of the Financial Security team in the Education and Outreach group at AARP. She leads AARP's educational and outreach efforts aimed at helping Americans achieve financial peace of mind in retirement. She can be reached at jsetzfand@aarp.org or on Twitter at @JSetz.

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