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Despite the hefty price tag, there's a piece of good news about retirees' health-care costs: They aren't rising as quickly as they were even a few years ago.
A healthy male-female couple retiring at age 65 in 2019 can expect to spend $285,000 on health-care expenses in retirement, according to Fidelity Investments' annual analysis, released Tuesday. Broken down by gender, the estimate is $150,000 for women and $135,000 for men.
The amount is up slightly from $280,000 in 2018. While the annual increase slowed over the last two years — 3.6 percent compared with 12.2 percent from 2015 to 2017 — the amount still poses a challenge for a nation that appears largely unprepared to cover the overall cost of retirement.
Nevertheless, because Medicare is the primary insurer for the 65-and-older crowd, various factors have led to slower increases in older Americans' health-care costs versus those of the general population.
The national health expenditure growth is anticipated to average 5.5 percent annually from 2017 through 2026, according to a 2018 report from the Center for Medicare & Medicaid Services' actuary.
In contrast, Medicare's per-capita spending is projected to grow at an annual rate of 4.6 percent through 2028, according to the Henry J. Kaiser Family Foundation.
"It does appear that Medicare is managing the increases a little better than the rest of the health-care system," said Hope Manion, senior vice president for Fidelity Workplace Consulting.
Fidelity's analysis, which assumes the two theoretical people are eligible for Medicare, includes premiums, copays and other cost-sharing expenses, along with prescription-drug costs.
And, it's just a starting point. Things that are not covered by Medicare — dental, basic vision, over-the-counter medicines, long-term care — would be on top of that $285,000 estimate.
The biggest unknown variable for retirees is long-term care, which includes help with daily living activities such as eating and dressing.
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"We recommend that folks think about their family history, look at their relative's health and their own health," Manion said. "It could be a significant cost for some but not for others, and it's hard to predict."
Someone turning 65 has a nearly 70 percent chance of needing long-term care services in the future, according to government data. There are insurance policies that cover those costs, although the premiums can be pricey. Some life insurance also comes with a rider that covers long-term-care costs.
Manion also advises that pre-retirees familiarize themselves with Medicare.
The program, which covers roughly 51 million older Americans, is not free. Part A (hospital coverage) comes with no cost, yet Part B (outpatient coverage) has an average monthly premium of $135.50 for 2019. For prescription coverage under Part D, the average premium is $32.50 this year.
Additional coverage and benefits also are available through either an Advantage Plan — which delivers Parts A and B, and typically Part D — or a Medigap policy, which is only available if you don't have an Advantage Plan. It helps cover the cost of copays, deductibles and the like.
It's also wise for pre-retirees to consider putting money in a health savings account. The money contributed is tax-deductible, and both the earnings and withdrawals — as long as they're for health-care expenses — are also not taxed. In other words, you get a triple tax benefit.
"All of us should be saving for retirement as much as we can, and taking advantage of the tax-advantaged accounts at our disposal," Manion said.
Also, if you're thinking about retiring from your job before you turn 65 (the age for Medicare eligibility), you also should have a plan in place to cover the time between your employer-sponsored health insurance and Medicare.
A law called COBRA allows you to remain with your workplace insurance, although you'd be responsible for paying the full premium. In addition, the law generally only allows continued coverage for a year and a half.
You also can explore your options through the health-care exchange (otherwise known as the Affordable Care Act.) Depending on your income, you could receive a subsidy to help pay for coverage.