Before you can address these costs, it's important to understand what Medicare and other insurance cover.
We can help you do just that – so you can make the decisions that are right for you. In general, you’ll have two types of medical expenses when you retire: traditional and long-term.
Traditional medical expenses
Medicare is designed to cover traditional expenses, such as doctor’s visits, prescriptions, in-hospital expenses and wellness exams. However, you’ll still need to budget $4,000 to $6,000 a year to cover out-of-pocket costs Medicare doesn’t pick up – including premiums and deductibles as well as any supplemental insurance.
Below is a quick overview of Medicare Parts A and B costs and coverage.
Standard Medical Components
Estimated Out-of-Pocket Cost (2014)*
|Expenses Not Covered
Covers medically necessary inpatient hospital care (including rooms, meals, general nursing and drugs), skilled nursing facility care, some nursing home care (if following an inpatient hospital stay) and hospice care.
Average monthly premium: $01
Benefit-period deductible: (days 1-60): $1,2162
|Long-term care costs
Medicare premiums, deductible, coinsurance and co-payments
Routine dental care and dentures
Routine hearing exams, fittings for hearing aids and hearing aids
Routine eye exams, glasses and contact lenses (unless after cataract surgery)
|Covers medically necessary doctor visits, outpatient medical care, durable medical equipment, some preventative care and other medically necessary services Part A doesn't cover, such as ambulance services, cardiovascular, cancer and diabetes screenings, and laboratory services.|
|Average monthly premium: $104.902,3,4
Annual deductible: $147
Premiums vary based on participant's income
Responsible for co-payments/coinsurance (For example, coinsurance may include paying 20% of all outpatient hospital services.)
*Source: Medicare, Kaiser Family Foundation, Edward Jones estimates.
Medicare doesn’t cover most long-term care costs
Of all the expenses Medicare doesn’t cover, long-term care is potentially the biggest. This type of care includes nursing homes, assisted living, in-home health care and adult day care. Costs vary according to the type and amount of care, but the price tag can add up: Using an average nursing home stay of 2.5 years, you’d need more than $200,000 in today’s dollars to cover this cost – and that doesn’t include the effects of inflation.
You can pay for long-term care by adding these costs to your budget or insuring against them. If you decide to pay for them out of pocket, your Edward Jones financial advisor can look at your entire financial picture and help you determine if your portfolio can withstand this potential cost.
Another option is to purchase some form of long-term care insurance. The policies and costs can vary dramatically, however, based on your age, health and gender, as well as the amount of coverage you desire.
Your Edward Jones financial advisor can help you evaluate the following:
- Amount of coverage
Look for a policy that offers the highest amount of long-term care coverage relative to other options, assuming the same premium.
- Potential for rising premiums
Insurance companies can raise their premiums even after you’ve purchased a policy. Make sure you read the fine print. Your Edward Jones financial advisor will work with you to make sure you understand all of this.
- Benefit of insurance vs. the “risk” of not needing it
As with any insurance policy, there's always the possibility that you’ll pay for coverage you’ll never use. But given the large potential costs of a long-term care stay, it’s important to weigh the cost of insurance with the risk of needing care and not having coverage to pay for it.
Health care costs are important, but they are also just one of many factors to consider when you look at your retirement picture. That's where your Edward Jones financial advisor comes in. By getting to know you and your whole financial picture, he or she can work with you on a personalized strategy to fit your needs.
How we can help
Your Edward Jones financial advisor can look at your entire financial picture and help you determine what solution may be right for you.
1 You must have paid 40 quarters of Medicare tax while employed. If you paid less than 40 quarters, you may pay a monthly premium of up to $426.
2 A benefit period begins when you're admitted and ends when you have not received inpatient or skilled nursing facility services for 60 straight days, at which point a new benefit period (and therefore a potential deductible) begins.
3 If you delay filing or refuse Part B when you become eligible, there could be a 10% premium surcharge for each year you are eligible but not enrolled.
4 Average monthly premium based on single taxable income of $85,000 or less or joint taxable income of $170,000 or less. For income above these levels, premiums will be higher.
Visit the federal Medicare websitefor more information or to determine if specific items are covered.
Edward Jones is a licensed insurance producer in all states and Washington, D.C., through Edward D. Jones & Co., L.P., and in California, New Mexico and Massachusetts through Edward Jones Insurance Agency of California, L.L.C.; Edward Jones Insurance Agency of New Mexico, L.L.C.; and Edward Jones Insurance Agency of Massachusetts, L.L.C.