For only the second time since it’s been estimating the totals, Fidelity Investments reported Wednesday that the average projected cost of health care expenses for retirees has gone down. A 65-year-old couple exiting the workforce in 2013 is estimated to need $220,000 to cover health care costs throughout their retirement, an 8% decrease from last year’s $240,000.

Fidelity Benefits Consulting, which has calculated the estimates since 2002, does not include nursing home costs in its projections, which apply to retirees with traditional Medicare insurance coverage. For many, health care will be the largest expense during retirement and Sunit Patel, senior vice president at Fidelity, tells EBN that unlike food or shelter, “which you can dial up or down,” health expenses associated with aging are relatively fixed, regardless of income bracket or savings.

“While this is great news for retirees in general, I think the expectations should be that trends … are going to go up,” Patel says. “I think if you asked a year or two ago, people would have been surprised.”

From 2002 to 2012, Fidelity’s estimate increased by an average of 6% a year. Only once before has it decreased – in 2011 because of a one-time adjustment around Medicare changes regarding out-of-pocket spending for prescription medication. Brad Kimler, executive vice president of Fidelity’s Benefits Consulting, says the drop may not amount to much in the long run.

“While lower, this year’s estimate is still daunting for many retirees, and it will consume a considerable amount of a couple’s retirement savings,” Kimler says. “It is extremely important that health care costs are factored into retirement savings strategies today so that retirees can be prepared to pay their medical bills throughout retirement.”

Factors that could have attributed to the price decline include a decreased utilization of medical services as Americans forgo treatment they can’t afford, smaller payments to providers and influx of baby boomers into the Medicare population, lowering its average age. This last cause will reverse itself as those boomers reach more expensive ages.

Participants continue to underestimate their retirement health care expenses. Fidelity says, in a recent survey of those ages 55 to 64, nearly half (48%) think they will need only $50,000 to pay for their retirement health care.

“Creating a plan and starting to save as early as possible are two key aspects of a successful retirement savings plan,” Kimler says. “But it’s also important to identify a specific retirement income stream to address health care costs in retirement. Having assets that are earmarked for health care expenses will help ensure retirees can cover these costs when they arise, as well as help manage their overall retirement savings portfolio.”

Patel says, regardless of the occasional dip, a health expense estimate “going up each year should be expected.” He recommends employers and employees work to craft benefits packages than anticipate these needs, such as an annuity earmarked for medical spending or, even better, a health savings account.

“The HSA provides a unique opportunity because of its triple tax advantage: going in tax-free, saving tax-free and spending tax-free. Of course, it needs to be complimented with saving in a 401(k), an IRA, etc.” Patel says. “It’s important for employees to try and understand what their health care costs in retirement might be, and to try to get their arms around that magnitude. Because there is a lot of uncertainty about the future; it seems really far away.”

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