Without Planning, Health-Care Costs Can Wreck Retirement

My mother spends hardly anything on health care. I'd love to say it's because she's in perfect health, but she isn't.

At 93, she's survived three strokes and does pretty well, but she has doctors for her heart, lungs, brain, ears, eyes, knees and feet. And, of course, she has a dentist.

Still, she's not only a survivor in the broader sense. She's also the survivor of a time when health-care benefits for retirees were more generous than they are now and will be in the future.

She has health-care coverage from my late father's job as a machinist at the Exxon refinery. And she has health-care coverage through the Texas teacher's system. Her expenses? Mostly the premiums she pays for Medicare.

For those of us approaching retirement, the picture is depressingly different. Most of us will be covered by Medicare and not much else. And while that coverage is valuable, by itself it isn't going to protect us from the ice-cold reality of rising health-care costs. The Employee Benefit Research Institute estimates that Medicare covers only 51 percent of expenses associated with health-care services for most people, and it doesn't kick in until age 65.

That's why it's important to pay attention to your health-care spending needs when you're looking at the adequacy of your retirement income.

"Health coverage is an important part of retirement security," said Tricia Neuman, vice president and director of the Kaiser Family Foundation's Medicare Policy Project. "When people think about retirement, they often focus on income and financial planning, but it's hard to have retirement security without good health coverage. It's particularly important for people not yet eligible for Medicare." A couple of years of high health-care costs before Medicare eligibility could chew through the savings you were expecting to last the rest of your life.

The percentage of large employers offering retiree health benefits dropped sharply after accounting rules were changed in 1988. The revisions required employers to account for money they expected to spend on retiree health care in the future. The decline in the number of plans has leveled off, but existing plans tend to pay less and charge more for health-care coverage. Many provide no coverage once you're eligible for Medicare.

Here's what you can expect under Medicare:

? Hospitalization coverage (Part A) is health insurance for which you've paid during your working life.