At any age, health care is a priority. But when you retire, you should probably focus more on health care than ever before. This is especially true for women. Women live longer, develop certain chronic conditions at a higher rate than men, and are more apt to experience medical limitations that directly affect their daily activities. That’s why it’s particularly important for women to factor in the cost of health care, including long-term care, as part of their retirement plan.
How much you will spend on health care during retirement generally depends on a number of variables including when you retire, how long you live, your relative health, and the cost of medical care in your area. A 2010 study estimates that out-of-pocket health care expense for a 65-year-old couple retiring in 2010 and living for 20 years will range from $250,000 to $430,000. That could mean an annual health-care expense of almost $21,500. According to the Bureau of Labor Statistics, the average long-term inflation rate for healthcare has been 5.53% per year.
Another important factor to consider is the availability of Medicare. In general, you will be eligible at the age of 65. But what if you retire at a younger age? There are a number of ways you can make sure you get health care coverage until Medicare kicks in such as having a long-term care plan. Your employer may offer health insurance coverage to its retiring employees, but this is the exception rather than the rule. If your employer doesn’t extend health benefits, you may be able to get insurance coverage through your spouse’s plan. If that’s not an option, you may need to buy a private health insurance policy (which could be costly) or extend your employer-sponsored coverage through COBRA.
As mentioned, most Americans automatically become entitled to Medicare when they turn 65. In fact, if you are already receiving Social Security benefits when you are 65, you won’t even have to apply—you will be automatically enrolled in Medicare. However, you will have to decide whether you need only Part A coverage (which is premium free for most retirees) or if you want to also purchase Part B coverage.
Part A, commonly referred to as the hospital insurance portion of Medicare, can help pay for your inpatient hospital care, plus home health care and hospice care. Part B helps cover other medical care such as physician services, laboratory tests, and physical therapy. You may also choose to enroll in a managed care plan or private fee-for-service plan under Medicare Part C (Medicare Advantage) if you want to pay fewer out-of-pocket health-care costs. And if you don’t already have adequate prescription drug coverage or belong to a Medicare Advantage Plan, you should consider joining a Medicare prescription drug plan offered in your area by a private company or insurer that has been approved by Medicare.
Unfortunately, Medicare won’t cover all your health-related expenses. For some types of care, you’ll have to satisfy a deductible and make co-payments. That’s why many retirees purchase a Medigap policy.
Unless you can afford to pay out of pocket for the things that Medicare doesn’t cover, including the annual co-payments and deductibles that apply to certain types of services, you may want to buy tome type of Medigap policy when you sign up for Medicare Part B. In most states, there are 10 standard Medigap policies available. Each of these policies offers certain basic core benefits, and all but the most basic policy (Plan A) offer various combinations of additional benefits designed to cover what Medicare does not. Although not all Medigap plans are available in every state, you should be able to find a plan that best meets your needs and budget.
When you first enroll in Medicare Part B at age 65 or older, you have a six-month Medigap open enrollment period. During that time, you have a right to buy the Medigap policy of your choice from a private insurance company, regardless of any health problems you may have. The company cannot refuse you a policy or charge you more than other open enrollment applicants.
Because women tend to live longer than men, they are at a higher risk of needing long-term care. And on average, women need care over a longer time (3.7 years) than men (2.2 years). With a longer life expectancy and a greater likelihood of needing long-term care, women often must confront their long-term care needs without the help of their spouse or possibly other family members. Long-term care can be expensive. An important part of planning is deciding how to pay for these services.
Buying long-term care (LTC) insurance is an option. While premiums may be costly, having LTC insurance may allow you to elect where you receive your care, the type of care you receive, and who provides care to you. Many LTC insurance policies pay for the cost of care provided in a nursing home, assisted-living facility, or at home, but the cost of coverage generally depends on your age and the policy benefits and options you purchase. And premiums can increase if the insurer raises its overall rates. Even with LTC insurance, you still may have some expenses not covered by LTC insurance. For example,
- Not all policies provide coverage for care in your home, even though that’s where most care is actually provided. While the cost of in-home care may be less than the cost of care provided in a nursing home, it can still be quite expensive.
- Most policies allow for the selection of an elimination period of between 10 days and 1 year, during which time you are responsible for payment of care.
- The LTC insurance benefit if often paid based on a daily or monthly maximum amount, which may not be enough to cover all the costs of care.
- While lifetime coverage may be selected, it can increase the premium cost significantly, and some policies may not offer that option. Another option that can be valuable, but also increase the premium expense considerable, is cost-of-living or inflation protection, which annually increases the daily insurance benefit based on a certain percentage.
- Most common LTC insurance benefit periods last from 1 year to 5 years, after which time the insurance coverage generally ends regardless of whether care is still being provided.
To encourage more individuals to buy long-term care insurance, many states have enacted Partnership programs that authorize private insurers to sell state-approved long-term care Partnership policies. Partnership policy owners, who expend policy benefits on long-term care services, will qualify for Medicaid without having to first spend all or most of their remaining assets (assuming they meet income and other eligibility requirements).
Government Benefits for Veterans
If you are a veteran, you may be eligible for long-term care services for service-related disabilities and for other health care through the Department of Veterans Affairs. Visit the Department of Veterans Affairs website (www.va.gov/healthbenefits) for more information.
Other Health-Care Factors to Consider
It’s clear that health care is an important factor in retirement planning. Here are some tips to consider:
- Evaluate your present health and project your future medical needs. Considering your family’s health history may help you determine the type of care you might need in later years.
- Don’t presume Medicare and Medigap insurance will cover all your expenses. For example, Medicare (Parts A and B) does not cover the cost of routine eye exams, most eyeglasses or contact lenses, or routing hearing exams or hearing aids. Include potential out-of-pocket costs in your plan.
- Even if you have Medicare and Medigap insurance, there are premiums, deductibles, and co-payments to consider.
You may have already begun saving for you retirement, or you could be retired already, but if you fail to include the cost of health care as a retirement expense, you are likely to find that health care costs can zap retirement income in a hurry, potentially leaving you financial strapped.