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Retirement Medical Costs Not So Scary?

When Seen Yearly

By Rick Kahler CFP®

Have you ever worried yourself into a frenzy over something, only to find out you were worrying about the wrong thing?

For example, researchers say that Baby Boomers are more worried about being financially devastated by unexpected health costs in retirement than they are about outliving their retirement savings.

But isn’t the cost of health care a legitimate worry?

We all have heard the stories of people who lost their homes, savings, and retirement portfolios paying for exorbitant medical expenses due to an unforeseen health problem. Just recently Fidelity reported that the average couple will spend $280,000 on health care in retirement.

What is often overlooked is that medical expenses before retirement are inherently more volatile than those after retirement. Before retirement, the variation in medical insurance premiums plays a huge role in the cost of medical care. Those who suffer the greatest losses from unexpected catastrophic medical expenses are often those who are uninsured.


The Affordable Care Act was designed to make it unusual for those with health insurance to suffer a catastrophic loss from unforeseen medical expenses. Still, the cost of paying for adequate health care can be staggering if you don’t qualify for a subsidy. In South Dakota, the monthly cost of providing health care for a family of four runs between $1,800 and $3,000 a month, depending on whether you hit the maximum annual out-of-pocket threshold.

While that cost alone could be considered catastrophic for some, the difference is that the potential cost is known and can be budgeted for. This is where Health Savings Accounts (HSAs) can be so effective, allowing a couple to put aside $7,000 in tax-deductible savings to use toward funding family out-of-pocket expenses. Any unused funds can be carried forward indefinitely to fund future out-of-pocket costs.

In the same way that insurance helps mitigate catastrophic health costs before retirement, so does Medicare almost eliminate unexpected health care costs after retirement. While it is true the average couple will spend $280,000 on health care in retirement, “the reality is that health care costs in retirement aren’t needed as a ‘lump sum’ on the day of retirement,” notes financial researcher Michael Kitces. In an October 2018 article, “Getting Real About (Annual) Health Care Costs In Retirement,” he points out that the Medicare system actually makes retirement health care costs a remarkably stable annual cost that can be planned for.


For example, a 65-year old couple with an income of under $170,000 will pay $270 a month in Medicare part B premiums. A Medicare Supplement plan to cover costs not paid by Medicare can run another $300 a month. This puts the monthly out-of-pocket expenses at $570 per month. Let’s further assume an additional $135 a month for ancillary expenses like dental and vision, for a total of $705 per month, or $8460 per year.

If we assume both spouses live for 23 more years after age 65, and we factor for inflation, they will spend $280,000 in retirement for medical expenses.

When we view retirement medical costs as ongoing monthly expenses rather than lumping 23 years into one large number, they are not that scary. As Kitces notes, “Of course, individual health care costs may still vary… but it turns out they vary in rather predictable and plannable ways.”




With that bit of knowledge, Baby Boomers can now stop worrying about being financially devastated by catastrophic medical expenses. Those who still need something to worry about can focus instead on what really counts: sufficient retirement income. This means saving enough for retirement and managing their income after retirement so they will have enough money to provide for the rest of their lives.


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One Response

  1. Medical Bankruptcy not so Common?


    Dr. David E. Marcinko MBA


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