Retirees and health care: Here's what it will cost you and how to prepare

Each year, financial services provider Fidelity conducts an estimate of how much a newly retired couple can expect to spend on health care throughout their retirement. And not surprisingly, the expected tab has increased for 2019 retirees.

According to the newest estimate, a 65-year-old couple retiring in 2019 can expect to spend a staggering $285,000 on health care expenses throughout their retirement – a $5,000 increase from the 2018 estimate. On an individual basis, this breaks down to $150,000 in health care expenses for the average retired woman and $135,000 for the average man. And it's worth pointing out that these are out-of-pocket expenditures beyond what is covered by Medicare.

Also, keep in mind that these are just averages. If your health turns out to be worse than the average retiree's, or if you end up living significantly longer than the average American, your out-of-pocket health care costs could end up being significantly higher. Furthermore, if you end up retiring before you reach 65, you won't be eligible for Medicare, so it's important to have a plan for health care expenses in the pre-Medicare years.

Use your tax-advantaged accounts to their full potential

If you're still decades away from retirement, the $285,000 figure in Fidelity's estimate likely won't apply to you – at least not exactly. There are simply too many variables that can change the cost of health care between now and when you retire.

Having said that, there's nothing to indicate that health care costs are going down anytime soon, so this cost estimate should serve as a wake-up call. After all, this is $285,000 that today's retirees will spend on health care in addition to the amount that they'll need for all of their other expenses.

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Hands down, the best way you can prepare for health care expenses in retirement is by maxing out your contributions to a health savings account, or HSA, if you qualify for one. These accounts are available to Americans with qualifying high-deductible health plans and have a unique triple tax benefit for health care expenses.

You can read our 2019 guide to HSAs for a thorough discussion of how these accounts work, but the general principle is that money is contributed on a pre-tax basis, so you don't pay any tax now on this portion of your income. The money in the account can be invested, and all dividends and capital gains are tax-deferred. Finally, any withdrawals used for qualifying health care expenses are 100% tax-free. So you can place some of your retirement savings in an HSA to reduce your tax liability, and therefore your cost burden, in retirement.

If you don't qualify for an HSA, it's still important to contribute aggressively to other tax-advantaged accounts, such as your 401(k) or 403(b) at work, or to a traditional or Roth IRA.

What you can do if you're ready to retire

If you're getting ready to retire, it's obviously not an option to attempt to set aside hundreds of thousands of additional dollars in tax-advantaged accounts. But there are still a few things you could do.

First, it's worthwhile to arm yourself with a good working knowledge of what Medicare Part A and Part B do and do not cover, so you'll know what to expect. You also may want to consider a Medicare Supplemental Insurance plan, also known as a Medigap plan, which can help keep your costs more predictable.

Also, if you're worried about having enough retirement income to cover your health care expenses, it can make a big difference to delay retirement (and Social Security) by a few years. Though not the most popular option, it can make a world of difference in your financial well-being after you retire. Not only will your Social Security benefit end up being larger for life, but postponing retirement gives you more time to stuff your tax-advantaged accounts with as much money as possible.

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