A definitive guide to retirement health-care costs

If you've made it through the five stages of pre-retirement grief (denial > anger > bargaining > strategizing a lottery win > frantically stuffing funds into IRAs to make up for lost time), congratulations! But don't go riding off to Florida or Arizona in search of your tiny dream home just yet.

While we may be conditioned to start saving for the golden years early and often, and even offered incentives like employer-sponsored matches, and retirement-specific savings plans with tax-deferred benefits, less clear is that health care beyond the age of 65 also requires extraordinary planning. Targeted savings figures for post-employment years will vary by person, although an estimate of the number needed to pay for health care in retirement is one-size-fits-many, and it's not small.

According to Fidelity Investments' 2019 analysis, the targeted savings figure for health-care costs in retirement for an average opposite-sex couple in their mid 60s is approximately $285,000 (after taxes) — a figure that factors in many costs not covered by Medicare, while not taking into account the price of long-term care.

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It's a heart-stopping sum to be sure, but rather than panic, you should instead get smart about staying healthy, both physically and fiscally. Here are some tips:

Medicare

On the first day of the month in which you turn 65, you're eligible to enroll in Medicare Parts A, B, and D.

Part A, which is premium-free if you or your spouse have worked in the United States within the past decade, covers the first 60 days of a hospital stay after a $1,364 deductible. After that, a daily co-pay is implemented and tops out at nearly $700 dollars a day until a lifetime maximum days is reached and hospitalization costs are no longer covered.

Part B, which is required along with Part A if Medicare is your primary insurance, costs $135.50 monthly for most people except those in a higher earning brackets, who pay an "income adjustment," or a higher rate for services like blood work, durable medical equipment, doctor visits, surgeries, and MRIs.

Part D offers a prescription card for discount medications, with an average monthly premium of $35.

Part C, also known as a Medicare Advantage Plan (similar to an HMO or PPO), is available via private companies that are Medicare-sanctioned. Part C includes A and B but boosts the coverage by offering additional services including vision, hearing, and dental. Medicare Advantage plans also usually include Part D as a rolled-in benefit.

HSAs

A health savings account (HSA) is a sleek way to contribute pre-tax money that's allowed to grow tax-free and then be used tax-free for qualified medical expenses. Even sleeker is if you're over 65 but still working and can take advantage of an employer's less-expensive high-deductible health insurance premiums by paying for most out-of-pocket costs using tax-free dollars. Individuals can kick in upto $3,500 annually and those over 55 can add another $1,000.

Health screenings

No- and low-cost health-care screenings can save you hundreds, if not thousands, in doctor fees and co-pays. In the past few years some of the major pharmacy chains have added wellness services to their menus, like CVS MinuteClinic medical clinics, which are staffed by nurse practitioners and physician assistants and open seven days a week to walk-in patients. Common illnesses such as strep throat, and ear, nose, eye, bladder, and bronchial infections can be diagnosed, and chronic conditions like high blood pressure, diabetes, asthma, and high cholesterol can also be screened and monitored.

Health fairs

Most community hospitals offer health fairs on at least an annual basis. The fairs are free and open to the public, while some services might come with a nominal fee. Participants can learn about their bone density and blood pressure, while getting free health screenings for cholesterol and sugar. Health fairs also usually offer flu shots, balance tests, and resource guidance on topics such as cancer, alcoholism, and obesity.

Approximate and budget

Health care is frequently the single largest expense in retirement, with Fidelity estimating 15 percent of the average retiree's annual budget is used towards medical care, including co-pays, dental, and vision services. Increased spending also should not be ignored, because even though expenditure growth actually slowed between 2018 and 2019, the projected rise over the next seven years is at least five percent annually. And yes, the numbers, percentages, and advice all change depending on when, how, and where you live. What remains a constant, though, is the importance of savings.