Nearly half of soon-to-be-retired, high-net-worth Americans say they are terrified of what health care costs may do to their retirement plans, according to a new survey.

Nationwide Financial's "Healthcare Costs in Retirement Consumer Study" found that 45% expect health care to be their biggest expense throughout retirement, while $5,621 was the amount participants expect to spend on health care each year on average.

A second study of retirees 65 years and older conducted by Extend Health mirrored Nationwide’s findings, with 22.8% saying their top concern about retirement today is having adequate health insurance compared to five years ago when nearly 27% said their top concern was maintaining their pre-retirement standard of living.

“These concerns are completely justifiable as managing health care costs remains a major financial challenge during retirement,” says Insured Retirement Institute President and CEO Cathy Weatherford. “Social Security, alone, will be insufficient to cover these costs. To ensure that a boomer has enough assets to meet health care costs in retirement will require a substantial investment into the hundreds of thousands of dollars.”

Nationwide reported that pre-retirees who plan to enroll in Medicare estimated that Medicare will pay 68% of their health care costs in retirement, but when asked how they arrived at that percentage, nearly three in four guessed or didn’t know.

While Medicare provides health coverage to 46 million older or disabled Americans, the government program currently covers only about 51% of the expenses associated with health care services, according to the Employee Benefit Research Institute.

On average, a healthy 65-year-old man can expect cumulative health care costs including premiums to reach $369,000 through the remainder of his life, according to IRI research. For a woman, the cost is estimated at about $417,000.

“Insurers and the financial planning community can work with Boomers to deploy strategies that can significantly reduce the total investment needed,” says Weatherford. “IRI’s research shows that by purchasing an annuity with a guaranteed minimum withdrawal benefit, a 55-year-old male has the potential to reduce the initial investment by more than 70%.”

Juliette Fairley writes for Insurance Networking News, a SourceMedia publication.

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