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Older Americans are increasingly worried about the health-care costs in their future, but few are taking steps in response.
That's the finding of a study released Wednesday by Ameriprise Financial, which found that 53 percent of baby boomers say they are "very concerned" about health-care costs in retirement.
They have reason to worry: a couple, both aged 65 and with typical prescription drug expenses, would need to have $255,000 in health-care savings to be 90 percent certain they can cover their expenses, according to the Employee Benefit Research Institute, or EBRI.
Even so, only 19 percent of the survey respondents said they were taking steps to prepare financially for their health-care costs in retirement.
There are a few bright spots for boomers facing retirement. EBRI's projections of health-care costs for retirees have fallen for two years in a row, for one thing. And while only 21 percent of the respondents in Ameriprise's new survey have purchased long-term care insurance, that figure is up from 13 percent a year earlier.
Pat O'Connell, executive vice president at Ameriprise, said he is encouraged that 88 percent of the survey respondents are aware that healthy lifestyle choices now will impact both their quality of life and financial well-being in retirement.
It is reasonable to look at the survey results "as a freight train bearing down on people," he said. "But to me, it would be a freight train you can do something about and get out of the way. People are thinking about doing something proactive."
Boomers have also gotten better at predicting their likely health-care costs in retirement, O'Connell said. "There is more coverage related to all issues of health care," he said, and for boomers in or near retirement, "this issue is becoming more and more relevant to them each year."
Carolyn McClanahan, a financial planner and former emergency medicine doctor in Jacksonville, Florida, said she takes her clients through a four-step process to help them prepare for health-care costs in retirement.
First, she has them determine what kind of health-care consumer they are. If they rarely visit the doctor and are in generally good health, they are likely to need less in health-care savings than if they go in for every hangnail and take a lot of prescription drugs.
McClanahan also encourages her clients to become empowered health-care consumers. When their doctors are prescribing tests, she teaches them to ask what the tests may show and whether the findings would change the treatment plan.
Advanced directives are McClanahan's third recommendation. (In the Ameriprise survey, only 32 percent of the respondents had such directives.) Usually when new clients come to her, they have not made their end-of-life wishes clear to their families; but now all but one of her clients has an advanced directive in place describing what they do and don't want doctors to do.
Without an advanced directive, "the default is to do everything, and everything is expensive," she said.
Fourth, McClanahan encourages clients to do what they can to take care of their health now.
McClanahan also discusses with her clients the advantages of working later in life. "Maintaining your human capital is the most important thing you can do to take care of your health," she said.
Continued employment may also let people continue with employer-sponsored health insurance. Given how little boomers are saving for health care, that's a prescription many of them may need.