Market Commentary – Long-term Care

I recently served as a panelist, along with Dr. Katy Votava, President of Goodcare.com, and Thomas West, ChFC, of Signature Estate & Investment Advisors, for a webcast sponsored by Investment News entitled, “Women in Retirement: Managing Longevity.”  With over 1,200 financial advisors registering to be in attendance, moderators Frederick Gabriel and Mary Beth Franklin attempted to shed light on a growing financial problem among Baby Boomers: most women retiring today are projected to outlive their savings.

As the founder of HVS Financial, I have been proselytizing for years about the financial dangers related to long-term care costs in retirement. Women are especially vulnerable financially because they have longer life expectancies than men and are often left without enough savings after their spouses pass on. Here are some important facts:

  • According to a Women and Long-Term Care Fact Sheet published by AARP,
    • Over 70% of nursing home residents are women
    • 70% of women 75 or older are widowed, divorced, or never married
    • 48% of Americans living alone are women compared to 22% of men
  • A healthy 58-year-old woman living in Boston will have a life expectancy of 90 years and close to a 50% chance of needing long-term care by age 88.
  • Average length of stay in a nursing home for a woman will be over 2 years
  • Average annual cost of nursing home care in the Boston area today is $123,000
  • Estimated annual cost 30 years from now will be $613,000

The aforementioned statistics are not the total story. Let’s say this 58-year-old woman is happily married to her husband of the same age. More than likely, she will live approximately five years longer.  Here are some other projections:

  • His life expectancy will be approximately 85 years
  • Average length of stay in a nursing home for a healthy 58 year old male will be 1.5 years
  • Estimated annual cost 25 years from now will be $495,000
  • Based on his potential 1.5-year stay, the couple may be responsible for $770,000 in nursing home expenses
  • Additionally, beginning at age 80, they will also be responsible for approximately $40,000 in health insurance premiums and other out of pocket healthcare expenses, such as co-pays
  • Note that the $40,000 mentioned above is the equivalent of around $22,000 in today’s dollars, not much more than the $16,000 cost of medical insurance premiums your current employer is paying for your family plan

According to Medicare, by 2020, between 12 and 14 million people are going to need some form of long-term care.  That means roughly 1 in 6 Boomers—or more importantly, one third of all couples—will require some level of LTC—enough to cripple a family’s life savings.

A common reaction is to assume that Medicaid is the solution. Think twice before depending on Medicaid, as benefits will likely be cut to help address the country’s deficit problems, and for the most part, current Medicaid benefits do not cover facilities with any real amenities. The key is to have assets available to cover the cost of at least a one-year stay.

On a personal note, since I am considerably older than my lovely wife Marea, I should probably keep these statistics and all sharp objects away from her (only kidding).  I am sure that she would not look forward to the possibility that keeping me alive in a nursing home might one day put her in the poorhouse.  Let’s face facts: LTC almost exclusively occurs during the final years of life, when loved ones are hooked up to a myriad of tubes and bags and often cannot perform the most basic daily functions.  I am sure that my wife cares about me very much and would do anything for me. But, writing a check for $500,000 a year just to keep me propped on some pillows is difficult for me to swallow.  What if it goes on for two years?  Three?

Fortunately, financial industry professionals are prepared to address this issue, and the time to act is now. Potential solutions to catastrophic long-term care costs include purchasing LTC insurance, looking into annuity products that offer long-term care riders, carving a portion of savings that can be allocated to LTC costs, and/or purchasing a universal life policy that offers LTC or catastrophic care riders (an additional benefit is related to the favorable tax status built into life policies).  Since the average Baby Boomer is looking at an investment period of 20 to 30 years, it is worth talking to an advisor about considering a more aggressive portfolio dedicated to LTC savings. If investors do not require LTC services, the accrued assets can be left to heirs.

Think about it: tackling this problem today could be the ultimate holiday gift for your spouse and children.

Happy Holidays!

The next Update will be posted on January 7, 2013.

The Update is written by Chris Leone and Ron Mastrogiovanni.

Social Security & Medicare go hand in hand – In order to get one the other must also be taken

With a court ruling back in 2011 Social Security & Medicare have become interlocked.

In March of 2011 federal Judge, Rosemary Collyer ruled that in order to receive Social Security a person would also have to enroll in Medicare, if the person refused Medicare for any reason then they would have to forfeit all Social Security benefits too.

This case was under appeal by the Cato Institute a right leaning organization on behalf of three Federal Employee Retirees who not only didn’t want Medicare coverage but actually didn’t need it because of the benefits they were receiving in retirement (the case eventually added two others as well who were not Fed Employee Retirees)

Well, earlier this year the ruling was upheld in a court of law, on Feb. 7, 2012, a federal appeals court ruled in Brian Hall, et al. v. Kathleen Sebelius, et al. that senior citizens who receive Social Security cannot reject their legal rights to Medicare benefits.

This ruling has now single handedly created the one expense that every single retiree will face – Medicare.

And guess what?

Medicare is not free.

Retirement Income: it is a major factor when determining your health care costs

The buzz in the financial world is around Retirement and more specifically it is all about Income in Retirement.

There are non-profits built around it, there are broker dealers designed solely to generate it and there are countless professionals from advisors, planners, life agents, CMO’s, wholesalers, back office personnel and authors talking it’s praises but what is the one thing that nobody is even whispering?

That this buzz will eventually be used against you when you retire and enroll into Medicare.

YUP – what everyone is talking about is the biggest factor determining your premiums for Medicare Parts B & D.

With the passing of the Medicare Modernization Act along with the Affordable Care Act new rules have been put into place that allows Medicare to “means test” a beneficiary’s income when it determines a beneficiaries premiums for Medicare Parts B & D and if there is too much there are penalties

For Part B the penalties range from 40% of additional premiums to 220% of additional premiums.

For Part D the penalties range from 35% of the National Standard Premium to 80% of the National Standard Premium.

The minimum amount of income Medicare will allow before a penalty is assessed is $85,000 for an individual and $170,000 for a couple, but please keep in mind that income is defined differently.

Medicare’s definition of income is “the total of your adjusted gross income and tax-exempt interest income you may have. These are the amounts on lines 37 and 8b of IRS form 1040. Some examples of income are: wages, salaries, tips, taxable interest, certain dividends, business income, capital gains, and unemployment compensation, as well as annuities, Social Security payments and some pensions”

Ultimately there are only 3 investment vehicles that do not register on Medicare’s radar

  • Life Insurance – the cash value in the form of a loan
  • Roth IRA/401ks – qualified distributions fly under the radar
  • HSAs

 

Please note that cash withdrawn through a reverse mortgage is also not counted (but the sale of a home can be especially if it’s a vacation home or a primary residency where the capital gains is larger than $250k/$500k).

 

So income is everything else including Tax Exempt income from Muni Bonds and we mean everything.

 

Think this is something that can be blown off?

 

Think again.

 

With health care costs setting a record pace upwards faster than any college could ever dream of those 55 year olds who do plan on retiring at age 65 can expect to incur roughly $302,000 in just Part B & D premiums if they both live to age 85, earn the minimum and reside in Nevada.

 

Keep in mind that this couple hasn’t even used their health coverage yet and plan to never need Dental, Hearing, Vision or routine tests throughout retirement and if they earn just $1 more throughout retirement they will pay;

 

$411,712 for the exact same coverage

 

If their financial professional convinces them to earn the most ($214k for an individual or $428k for a couple) they will pay;

 

$910,577

 

Hopefully no one will be in this bracket throughout retirement, but it can happen to almost any high networth investor who isn’t paying attention. All it will take is the sale of a home for too much, plus a distribution here or there & presto they are paying the max for the year.

 

Think it’s impossible?

 

There is a sales idea brewing out there now for high networth investors to avoid the new 3.8% surtax on investment income over $250,000 and this could lead to disaster for those who take their eye off the ball later in life.

 

The idea is convince these HNW investors to move a portion of their investments into Muni Bonds to avoid the 3.8% surtax and generate income that way.

 

Under the new rules dividends are not included when determining the surtax but they are included when determining your premiums – so please be careful. I’m willing to bet the farm that this little tidbit will be left out of the conversation

 

 

 

Weekly Update

In my last update, I proselytized about the cost of healthcare and long-term care, which will undoubtedly be the two largest expenses most Americans will face in retirement. One Update reader—let’s call him Ray (his name is Ray)—offered a rather callow solution to the issue. I say callow because it’s one of my favorite new words, and it also describes how Ray and the majority of Baby Boomers do not fully grasp the cryptic Medicare system. However, for those who do their homework and learn the intricacies of the program, it can be like putting money in the bank.

 

The following is a summary of Ray’s strategies and my subsequent attempt to provide him with a harsh—but truthful—dose of reality.

 

Ray and his wife, Dee, will retire in one year at the age of 63, and they intend to sign up for Social Security, which they believe entitles them to Medicare services.

 

Mistake number one.

 

Social Security and Medicare are two completely different programs. Ray and Dee may sign up for Social Security at age 63, but they will not be eligible for Medicare until age 65. Assuming they are a healthy couple, the cost of private insurance will exceed $40,000 for the two-year period prior to Medicare eligibility: a cost that many simply fail to budget.

 

When Ray and Dee do finally subscribe to Medicare at 65, they are going to be struck with another surprise: Medicare is not free, and the program covers only about 51% of healthcare services. The other 49% includes long-term care (which we will cover later), hearing aids, routine dental work including dentures co-pays, certain doctor visits, vision, and the list goes on.

 

Ray’s pell-mell knee jerk response was that he could simply purchase private insurance coverage and not enroll in Medicare, given the countless issues associated with the program.

 

Mistake number two.

 

Medicare is the only game in town. Fortunately, Medicare is a well-run program that delivers healthcare funding administered by the private sector, not the government. Also, the cost of medical services under Medicare is growing at a substantially lower inflation rate than private insurance plans. As a matter of fact, experts predict that Medicare will likely grow at an inflation rate equivalent to the nation’s historical average.

 

Here are our couple’s health insurance choices at age 65. They may purchase traditional Medicare services including Medicare A (hospital insurance), Medicare B (insurance covering doctor visits and tests), Medicare D (prescription drug insurance), and Medigap insurance (fees for services not covered by Medicare A and B). The second alternative is to purchase a Medicare Advantage Plan. A Medicare Advantage plan is a health insurance plan offered by private companies and funded by Medicare. At a minimum, they are the equivalent of Medicare A and B, and many plans offer the same level of coverage as Medicare A,B,D and gap insurance.

 

The usually jaunty Ray began to appear disquieted by this point, and then the discussion turned to long-term care.  Ray and Dee are counting on Medicare to cover nursing home expenses, and therefore feel it is completely unnecessary to save for long-term care.

 

Unfortunately, the truth of the matter can pretty much be summed up by Edward Cole in the Bucket List, who said, “Somewhere, some lucky guy’s having a heart attack.”

 

Here is the stark reality: breakthroughs in medical science and lifestyle modifications have increased average life expectancy, but long life comes with a price, especially since it escalates the likelihood that some form of long-term care will be needed. In Ray’s defense, many are under the false assumption that Medicare covers this expense.

 

Please, for one moment, indulge me by allowing me to scream at the top of my lungs.

 

Medicare is not responsible for the MAJORITY of Long-term care EXPENSES!

 

Consequently, given a normal life expectancy, this couple may face a future expense totaling approximately $1.9 million ($834,000 in today’s dollars) should they both reside in a nursing home for an average length of stay, which is usually anywhere between one and two years.

 

Think about it; the consequence of not planning for healthcare in retirement could become downright tragic for many, with nursing homes and long-term care facilities potentially eviscerating lifetimes of toil and savings in a few short years.

 

However, most Boomers will not require long-term care for another 25 years and spend little, if any time at all, considering its impact.  Well, it’s time to go back to our old friend Ed Cole, who, in response to his friend, Carter Chambers’ assertion that “forty five years goes pretty fast,” replies

 

“Like smoke through a keyhole.”

 

Don’t wait. Start planning now.

 

 

This update is co-authored by Ron Mastrogiovanni and Chris Leone

Another look at the $240,000 health care cost in retirement number

There has been a lot of talk about Fidelity’s $240,000 healthcare-expense-in-retirement estimation.  I tried to examine it from an unbiased perspective and came to two distinct possibilities:

 

1)      Fidelity has solved the healthcare crisis, or

2)      We need to step back and rethink the number.

 

Let’s look at an example of a 30-year-old working today.  Let’s call him Phil.  Phil Delity.

 

Phil is working for a large company that has provided him with a fair benefits package.  He can expect to pay roughly $215 per month for his premiums, or about 25% of the total, with the employer picking up the remaining 75%.

 

Projecting for the year, Phil will pay a total of $2,580, while his employer will cover the remaining $7,594, so his yearly premium will cost roughly around $10,200.  This seems to be a fairly accurate assessment according to a 2011report from the Houston Business Journal, which used AON Hewitt data to peg total healthcare costs per employee at $10,770 annually, while Milliman pegs a family’s healthcare costs to exceed over $20,000 in 2012.

 

So if Phil stays with the company until he is 50 and incurs approximately $10,000 in healthcare cares costs per year, his total coverage costs should slightly exceed $200,000. (This does NOT take inflation into account.)

 

Still with me?

 

Now Fidelity has led the financial industry to believe that when Phil reaches 65, enrolls in Medicare with his spouse (Phil got married along the way), the two of them should only expect to pay $240,000 for their healthcare for the rest of their lives.

 

Now the question becomes: How does one healthy individual over a 20-year period pay roughly $200,000 for healthcare, but TWO elderly people who live to 80 —with additional variables such as increased medical testing, prescription drug dependency, and long-term care—expect to pay only $40,000 more in costs?  This figure also fails to take into account that Medicare is now means tested, which translates to the “more you earn, the more you pay.”

 

Either Fidelity wants everyone to believe that no one will live that long (so why bother even planning anyway) or they have figured out a way to lower health costs for everyone as they age.

 

I hope that I am not the only one baffled by this.

 

Now if we turn to Healthview Services, an industry leader healthcare cost planning, we will see, by using their revolutionary RetireMark Software, that a couple who is 65 today and only plans to live until age 80 can expect to incur $274,000 in retirement. This number changes drastically if the couple’s income ever exceeds $170,000, they move to a more expensive state, or they live to their actual life expectancy. (88 years for the male and 90 for the female, which will result in approximately $620,000 for their healthcare costs.)

 

Something just doesn’t add up, and unfortunately this misinformation will lead to erroneous planning in which the only real losers will be the clients.

Impact of Medicare’s defintion of income on Defined Benefit Plans

Small business owners who have set up a defined benefit plan for themselves and/or key employees may NOT be helping themselves out at all, especially if it comes in the form of a lump sum at retirement and is not structured inside a life insurance product.

 

Why? You may ask…

 

Medicare is now means tested.

 

Translation?

 

Medicare is now using income in retirement to determine premiums for Parts B & D.   Unfortunately defined benefit plans aren’t looking as attractive as they used to since the income will count against beneficiaries in the eyes of Medicare.

 

For example, a 55-year-old who retires from a credible health plan at age 65, enrolls in Medicare when eligible, plans to live until age 85, and earns under $85k a year in income (as defined by Medicare) can expect to incur over $199,180 in costs to just cover Part B & D premiums – source Healthview Services.

Notice, however, what happens if this person sells a property and jumps into a higher income bracket:

Earnings Basic Healthcare Costs Difference
$85,000 – $107,000 $275, 819 38%
$107,000 – 160,000* $293,738 97%
$160,000-$214,000 $509,436 155%
Over $214,000 $626,483 214%

 

*Once an income bracket is reached, there is significant red tape to revert back to a lower bracket.  Many may remain at the highest level for the rest of their lives—even if total income eclipses a higher bracket for only one year.

 

According to Medicare, there are only five occasions when a bracket can be changed:

  •  You married, divorced, or became widowed;
  • You or your spouse stopped working or reduced your work hours;
  • You or your spouse lost income-producing property due to a disaster or other event beyond your control;
  • You or your spouse experienced a scheduled cessation, termination, or reorganization of an employer’s pension plan; or
  • You or your spouse received a settlement from an employer or former employer because of the employer’s closure, bankruptcy, or reorganization. 

 

Please note that Medicare defines income as the total of your adjusted gross income and tax-exempt interest income you may have. These are the amounts on lines 37 and 8b of IRS from 1040. Some examples of income are: wages, salaries, tips, taxable interest, certain dividends, business income, capital gains, and unemployment compensation, as well as annuities, Social Security payments and some pensions.  This includes all gains and dividends from investments, no matter what they are.  Even municipal bond dividends get added to total income.

 

What isn’t income?  Distributions from Roth IRA’s and cash values inside permanent life insurance policies.

 

Perhaps it’s time to redefine defined benefit plans or those that do receive them must realize that there are more than just taxes to contend with.

States ranking when it comes to healthcare costs in retirement

Believe or not, where retirees choose to live can greatly impact how much they will pay for healthcare over the long term, especially when it comes to premiums.

Using HVS Financial’s RetireMark Software tools (click here for free trial) we analyzed the data of a 65-year-old couple who are;

  • Healthy
  • Retired as of today
  • Have longevity projections of 85
  • Will earn under $170,000 in income as defined by Medicare throughout retirement.
  • Want to cover premiums for Medicare Part B, Part D, and a MediGap (Plan C) supplemental policy

The cheapest place to live, which came as a shock, is Hawaii ($271,284) and the most expensive (not so much of a shock) is New Jersey ($362,844).

A whopping 33.7% difference exists between the two states.

The determining cost factor among states is simply supply vs. demand. Part B will be a constant for every individual in the U.S. who has paid into the system and whose earnings fall below the Medicare minimum, but Part D and the MediGap Policies are sold by private insurance companies that control prices (with Medicare setting some standards).

So Hawaii, which has a smaller retired population and slightly healthier residents than the rest of the country, will enjoy the lowest healthcare premiums. Conversely New Jersey, with a much larger population (that ostensibly needs extensive healthcare) than Hawaii, is much more expensive because the premiums set by the private insurance companies are higher.

Here is a complete breakdown of how each state stacked up including D.C. and the National Average

Rank State  Costs
1 Hawaii  $ 271,284
2 Vermont  $ 287,754
3 South Dakota  $ 299,714
4 Maine  $ 301,094
5 New Mexico  $ 303,314
6 Montana  $ 304,574
7 North Dakota  $ 307,084
8 Idaho  $ 309,284
9 New Hampshire  $ 313,344
10 Iowa  $ 314,194
11 Washington  $ 315,524
12 Oregon  $ 317,634
13 Minnesota  $ 318,114
14 Wisconsin  $ 319,204
15 Arkansas  $ 319,434
16 Wyoming  $ 320,064
17 Virginia  $ 320,574
18 Nebraska  $ 321,944
19 Rhode Island  $ 322,834
20 South Carolina  $ 323,724
21 Missouri  $ 324,034
22 West Virginia  $ 324,234
23 North Carolina  $ 324,414
24 Georgia  $ 326,664
25 Tennessee  $ 327,684
26 Kentucky  $ 329,534
27 Kansas  $ 331,354
28 Delaware  $ 332,734
29 Washington D.C.  $ 332,914
30 Utah  $ 333,014
31 Indiana  $ 333,464
32 Pennsylvania  $ 334,364
33 Ohio  $ 334,664
34 Colorado  $ 335,294
35 National Average  $ 335,434
36 Connecticut  $ 336,594
37 Alabama  $ 336,844
38 Oklahoma  $ 337,004
39 Mississippi  $ 338,264
40 Arizona  $ 338,364
41 New York  $ 338,624
42 Texas  $ 338,744
43 Illinois  $ 339,814
44 Massachusetts  $ 340,264
45 Louisiana  $ 342,164
46 California  $ 345,224
47 Alaska  $ 348,044
48 Nevada  $ 353,514
49 Michigan  $ 354,474
50 Maryland  $ 355,904
51 Florida  $ 362,544
52 New Jersey  $ 362,844

Boomers turning home equity into 401ks – The impact on Medicare premiums could prove costly

With the onset of Baby Boomers starting to retire we are beginning to hear  the question from more than a few of them, “why am I paying more for Medicare premiums than others?”

Here is the  article on the subject  from HometownAnnapolis.com.

The answer to this question is Income.

If you make too much of it in retirement you will unfortunately, pay more for your healthcare. Thanks to the Medicare Modernization Act of 2007 & the Affordable Care Act (healthcare reform) it paved the way with new legislation that allows Medicare to charge higher premiums for those that earn “too much” income in retirement.

These two acts also allowed Medicare to define income differently than the IRS. Now, Medicare through Social Security will  add your adjusted gross income together with your tax-exempt interest income to get an amount called the modified adjusted gross income (MAGI).

In layman terms, everything that hits your tax return is now considered income – yes, that is right,  EVERYTHING.

Social Security, wages from work, returns on investments, dividends (even if it’s from a Muni Bond) capital gain payouts, the sale of vacation home, too much return on the sale of a primary residency… EVERYTHING!

With such a broad sweeping issue looming hopefully, enough financial professionals will take notice of this growing concern, adjust their planning accordingly and the problem will be rectified easily but from the latest article from MarketWatch there is room for a lot of worry.

The article titled “Boomers turn home equity into 401k funds” highlights how little is known on Medicare & income.

People who decide to do what is recommended in this article, rip out all their equity from thier home & invest the cash into a 401k vehicle, must realize that when they start to liquidate these monies they will be classified as INCOME.

Is this a problem?

Only if you like paying anywhere from 50% to about 200% more on Medicare premiums so you can “invest” at a tax free rate now of roughly 20%.

As stated previously, Medicare counts everything that hits a tax a return before deductions as INCOME and the penalties are high, which is what Baby Boomers are quickly learning (See article here).

How high can the penalties be?

For a 65 year old who earns under $85,000 throughout retirement and lives to age 85 – they can expect to pay roughly $58,000 in premiums.

If they earn just $1 more over the course of retirement they will pay $80,000

If they earn over $214,000 then they can expect to pay roughly $182,000 FOR THE SAME COVERAGE.

Again, if the financial industry wakes up to this issue it won’t be an issue but from the looks of it a lot of people are going to be in big trouble.

Fidelity’s Health Care Number ($240,000) is Close but…

Fidelity is stating that average couple will need $240,000 at the point of retirement to cover their Health Costs in retirement.

Are they right or are they wrong or are they just really close?

The answer comes down to how you look at the data (our original post on the subject).

First off, Fidelity has given some details to how they figured the amount. They are stating that they are calculating for Medicare Part B & D premiums and then the rest of the costs will have to come out of pocket of the couple. They are assuming a 6.6% rate of inflation on overall health care costs compounded annually and that the monies earmarked for these costs will earn a compounded rate of 4% throughout retirement.

Finally, they are using life expectancies of 82 for a male & 85 for a female, while claiming that the couple is in average health with no chronic conditions.

Now, what we do know as a fact is that Medicare Part B, for the average person turning 65 in 2012, is $99.90 a month or $1,198.80 per person. We also know by estimates that the average Medicare Part D premium is roughly $400 per year per person.

That leaves us with $1,598.80 per person. If we then compound this number by 6.6% for 18 years for the male and 21 for the female the total the couple will spend in retirement to cover their Health Care expenses is $125,565.

All this couple will need as assets to earmark at retirement, which should be considered as today, will be roughly $57,306- this amount will also have to earn a 4% compounded rate for the next 20 years too.

Now, this seems a little a low, but what we also know is that there will be other costs that can be covered that we can factor in.

We know that there are deductibles and co pays for Medicare Parts A & B (please see Is Medicare Free?), we know that there are expenses if our hospitalization stay is too long or if we need more blood for our procedures. We also know that there are excess charges & costs that are just not covered, like co pays & deductibles for Medicare Part D.

We also know that most of these costs listed above can be covered by a MediGap Policy. These policies  were created specifically to help fill the in “gaps” that original Medicare had created and for some reason the number provided by Fidelity doesn’t seem to include them

MediGap Plans are administered by private insurance companies who have been approved by Medicare to be able to have the opportunity to sell MediGap Policies in each state. The rates, term & conditions of these Policies will fluctuate between each company selling them and each state they are sold in (to see if your state is the cheapest or the most expensive click here).

So with all of this information, how do can we find out what these costs of MediGap Policies and the remaining out of pocket costs will be?

By turning to HealthView Services, we can learn that the National Average cost for a MediGap Plan C Policy is roughly $1,500 per year per person and the National Average out of pocket costs is roughly $700 per person.

These two costs now bring our total to $3,398.80 per person at age 65. If we then compound the numbers by 6.6% for 18 & 21  years we will total $301,901 and all that this couple will need at retirement/today is roughly $197,525, at a 4% compounded interest rate.

But, even that number seems too low when comparing it Fidelity, so let’s look at HealthView Services’ own RetireMark Software to see what is typical for a 65 year average healthy couple who happens to reside in Ohio & earns less than $170,000 annually (Yes, where you live, what health conditions you have & how much you make are as important to figuring out what your costs will be as when you retire & when you expect to die).

The first thing we learn is that the actuarial tables from this decade peg “average healthy persons” on a different life expectancy as someone who has say Cancer. A male should expect to live to age 88 and a female to age 90.

With this new lease on life their costs are calculated to be $492,850.00 throughout retirement and the monies need at the point of retirement/today is $278,399.92 (please note that there has to be a compounded 4% earned each year on these earmarked assets)

If we are to use Fidelity’s life expectancies in RetireMark’s Software the total costs are $305,200.00 and the amount needed at retirement/today is $198,505.77 at a compounded 4% interest rate for this couple who happens to reside.

The side note to this is that RetireMark’s Software is assuming that the user will purchase a MediGap Policy to help offset Health Care Costs while Fidelity assumes that these costs will be paid for by the user.

So if we are to assume that the couple retires today, is in average health, lives in a state that is closest to the National Average, earns less than $170,000, will purchase a MediGap Plan C Policy, will earn a compounded 4% interest rate on monies earmarked for this expense over the course of 20 years and will never ever ever ever have a health condition throughout retirement while having the male pass away at 82 and the female at 85 then the Health Care Number is more like $198,505.77.

If you are not like this, well then your number is going to be different.

How different?

If you have average health, live in Hawaii, have a Fidelity life expectancy and your income is under $170,000 then the total amount spent in retirement will be roughly $244,640.00 and the amount needed at retirement/today is $159,522.35

If you happen to be a couple who has an income defined by Medicare to be over $214,000 per year, happen to live in Florida, both live until age 90 where the male has High Cholesterol and the female has Type II Diabetes your Health Care number will look a lot like $801,162.00 throughout retirement and you will need $442,509.87 at retirement/today.

So is the number really $240,000?

Maybe, if you are a couple who are both aged 65 today, you both have no health conditions and will not have any for the rest of your lives, you will earn less than $170K per definition of Medicare annually as income for the rest of your lives, you will reside in Vermont, and for the male you will have a life expectancy of 82 and for the female you will have a life expectancy of 84.

Then your number will be $251,154

It’s great to know that something that is so personalized like a person’s health can now be broken down to one generic number that everyone who is “average” should use.

Sort of makes financial planning even simpler to do now too.

Health Care Costs in Retirement

Healthcare costs by definition is the expenses related to the delivery of services that include medical procedures, therapies, and medications.

It is a simple definition that covers one of the more complex issues Baby Boomers will face as they head into retirement, and one that has become even more complex due to recent legislation like the Affordable Care Act and the Medicare Modernization Act.

At the birth of Medicare in 1965, Lyndon Johnson’s Great Society Act was a way to simplify health coverage for retirees 65 and over. It provided hospital insurance under the Social Security Act, with a supplementary medical benefits program and an extension of medical assistance for the aged.

Unfortunately today, a modest plan intended to cover about 12 million beneficiaries has now amassed 47 million subscribers, with another 78 million on the way in the next twenty years. 

Aside from massive migration to the program, this once-simple and much-lauded subsidy now consists of an incalculable amount of complexities, including ever-evolving rules and regulations, coverage gaps, loopholes, benefit changes and out-of-pocket costs than ever before. 

In an attempt to present the program in a manageable form for consumers, here are today’s Medicare costs in the most simplistic of terms:

Part A – No premium for those who qualify, but there are some hidden costs like deductibles and co-pays for services (for more on Part A click here).

Part B – a $99.90 monthly premium for those earning under the average amount plus other deductibles, co-pays, and excess charges (for more on Part B click here).

Part D (Drug Coverage) – Premiums (also based on income), deductibles, co-pays & other charges based on the terms & conditions of the Insurance Company selling the plan (for more on Part D click here).

MediGap – This form of coverage takes care of the co-pays, deductibles, & excess charges of Parts A and B, but here are fairly high premiums. (for more on MediGap Plans click here).

Other Out of Pocket Expenses – Medicare does NOT cover dental, vision, hearing, podiatry, or routine exams/physicals. Medicare will only cover procedures after a beneficiary has been admitted as an inpatient to a hospital.

So what do these costs total?

 

Simple.

 

It all depends on the person, where they live, how much they earn, how long they live, their gender, and the age they start receiving benefits.

Confused?

Here is the range of what 65-year-old couple residing in Ohio can expect to pay in out-of-pocket expenses.  Changes in variables can have a tremendous impact on overall cost. 

Current Age

Age of Retirement

Life Expectancy

Health Status

ST

Medicare Parts A,B, D + MediGap

Supplemental Coverage

Income

Total

Both 65

Both 65

88/90

Good

OH

Yes

No

Under $170,000

$473,970

Both 65

Both 65

88/90

Good

OH

Yes

No

Over $170,000

$513,554

Both 55

Both 65

88/90

Good

OH

Yes

No

Under $170,000

$913,170

Both 65

Both 65

88/90

Good

FL

Yes

No

Under $170,000

$550,854

Both 65

Both 65

77/88

Diabetes -M

CV Disease-F

OH

Yes

No

Under $170,000

$306,214

Both 55

Both 65

77/88

Diabetes -M

CV Disease-F

OH

Yes

No

Under $170.000

$511,730

Both 55

Both 65

77/88

Diabetes -M

CV Disease-F

OH

Yes

Dental, Vision, Hearing

Under $170.000

$562,830

Both 55

Both 65

77/88

Diabetes -M

CV Disease-F

OH

Yes

Dental, Vision, Hearing +  1 Year in Nursing Home

Under $170.000

$788.047

 

As the chart indicates, each variable can have a tremendous impact on what retirees can be expected to pay.  This information is vital to any financial planner who is truly looking out for the long-term interest of his/her clients

To find out more on determining health care costs in retirement please click here for a free trial of HVS Financial’s RetireMark Health software  Invitation Code – APRSH73RW