Those TV commercials showing retirees driving off into a blazing sunset stress the point that people have a sunnier view of the future than the past, which speaks to the need to be realistic in retirement planning. 

Predicting health-care spending in retirement is one of the biggest challenges in financial planning. Medicare covers a lot, but not everything.

Many Americans think that being eligible for Medicare — a federal health insurance program primarily for people who are 65 or older — means they’ll no longer need to worry about healthcare costs in retirement. That program, however, doesn’t cover many expenses, including premiums, deductibles and co-payments.

Whether you’re just starting to save for retirement or are about to age into Medicare, it’s important to understand the potential healthcare costs you may incur. The average 65-year-old couple could pay almost $490,000 in total health-related costs throughout retirement, according to Health View Services, a software company that projects healthcare costs. Here’s how healthcare expenses for retirees can add up.

To start, Medicare simply doesn’t cover a range of expenses, such as dental services, prescription eyewear, hearing aids and related exams. Nor will Medicare pay for long-term care expenses for chronic conditions or disabilities.

Medicare is divided into different types of coverage: Medicare Part A covers hospital coverage and short-term rehab care at home, according to Part B covers doctors’ services and Part D covers prescription drugs. Most people pay no premiums for Part A. But you do have to pay a deductible for each hospital stay.

For Medicare Part B, seniors must pay a monthly premium and a one-time annual deductible. In addition, Medicare recipients pay 20 percent of the remaining costs for any Part B service, with no limits.

If you see a lot of specialists, that can add up over time. Part D prescription drug coverage also has a monthly premium, as well as co-pays. Many seniors purchase supplemental coverage to help pay for the cost-sharing requirements in Medicare. These plans can be purchased through an employer or through the federal Medigap.

The key is to plan ahead. Although health care costs continue to rise, there are financial planning steps that you can take today to help prevent health care costs from eating into your retirement lifestyle.

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