How to Plan for Rising Health-Care Costs

Health care is one of the biggest expenses in retirement and also the most unpredictable, which makes planning for it difficult.

With life expectancy continuing to increase, the likelihood that you’ll need some form of long-term care is also on the rise.

“If you make it to 65, there’s a 70% chance you’ll need long term care,” says Brad Bernstein, senior vice president at UBS. “Unfortunately, not all Americans can afford long-term care insurance.”

There are savings options when it comes to putting away money to protect against future illness. From taking out the right insurance policy, to relying on a fully-funded health savings account, here are ways to start planning now to avoid the pain of costly medical bills in retirement.

Long-Term Insurance

When it comes to taking out long-term care insurance, timing is everything. And according to Bernstein, the sweet spot is around 55.

He says buying it ahead of this birthday is a waste of money, but getting it far after will bring much higher premiums.

Consider this: According to Bernstein, a married couple who buys long-term care insurance in their 50s will pay anywhere from $1,506 to $7,802 a month. Waiting until their 60s, pushes premiums up anywhere from $2,224 to $11,318. At age 70 and older, he says you may not qualify for coverage at all or not be able to afford the high premiums.

Long-term care doesn’t insure every expense, but it will cover assisted living or 24-hour home health care.

Hybrid Insurance

Another option for people who want to use insurance as protection against medical costs is a hybrid approach to long term care insurance, says Bernstein. This option is ideal for people who have enough cash to put $50,000 per individual or $100,000 per couple into a hybrid insurance product that gives a guaranteed long-term care benefit as well as a death benefit if one of the spouses passes, he explains.

“With traditional long-term care, there is no guarantee,” says Bernstein. “With a hybrid, there’s a guarantee you’ll make a return on your investment.” What’s more, Bernstein says your returns can be passed on to any beneficiary tax free, and you can take money out whenever you need it penalty free after five years from the purchase date. “This vehicle is most appropriate if you have at least $1.5 million or more,” he says. “People with that much who use $100,000 won’t destroy their income.”

Beef Up an HSA

He says people can also save for medical costs in retirement by using a health savings account, says Matthew Jehn, managing partner at Royal Oak Financial Group.

With an HSA, those still in the workforce can put money away from their paychecks on a pretax basis and use it for qualified health-care costs prior to retiring.

While the qualifying costs will differ from one account to the next, they typically include prescriptions, eye glasses, dental and major and minor medical. Jehn says it’s also a great way for people who want to retire early, but have to wait until they are 65 for Medicaid to kick in.

“For clients wanting to retire early, we have them set up a HSA and scale back on some of their 401(k) funding to fund the HSA,” he says. With a HSA an individual can contribute up to $3,350 + 1,000 catch up for 55 and up a year and married couples can contribute $6,650 + 1,000 catch up for 55 and up. Not only can the money be spent tax free by going this route, it also reduces your gross taxable wages, which means you’ll owe Uncle Sam less.

In addition to funding a HSA and letting the money roll over until you retire, Jehn says people nearing retirement should invest with an eye toward generating income. That could mean, for example, investing in dividend-paying stocks. “Having an investment portfolio that generates cash to pay for some of these things the HSA hasn’t is a wonderful option,” he says.