Your Finance: Budget retirement health care

Even if you're healthy, medical costs are likely to take up a large and growing percentage of your retirement budget.

HVS Financial, a Danvers, Mass., consulting firm, calculates that a healthy, moderate-income couple retiring at 66 should have $122,541 set aside (assuming 8 percent annual returns) just to cover its medical costs. Fidelity Investments has reported that a couple of 65-year-olds retiring today on average would need $240,000 banked to pay for health care.

Here are a few pointers:

Insure against runaway costs. Your health profile may matter less than your income in terms of how much you ultimately spend. It's true that some unlucky people have severe and chronic illnesses that drain their household budgets. But many people insure against runaway costs by buying a high-end supplemental Medigap insurance policy that will cover expenses that Medicare won't. That makes their health care costs more predictable and manageable.

What may push up your health care costs is being wealthy -- Medicare premiums for Part B (which covers outpatient care) and Part D (for drugs) are on a steep scale. Singles earning more than $214,000 or couples making in excess of $428,000 can expect to spend almost $2 million more in their lifetimes on Medicare premiums.

Put funds aside for health care. You may want to mentally segregate health care costs during the saving years. Sunit Patel, a retirement health care expert with Fidelity Investments, recommends that pre-retired couples plan to accumulate enough for their health care needs (such as his $240,000 for couples figure), and enough other savings and investments to cover roughly 60 percent of their working income.

But you may not want to invest them separately. It makes more sense, during the working and saving years, to keep the money invested as part of a more broadly diversified portfolio.

After retirement, you may have to manage income. Big income-producing events, such as the sale of a vacation home or large 401(k) withdrawals, could push you into higher Medicare premium levels.

Invest accordingly. If the bulk of your retirement health care expenses will be in premiums, then it makes sense to manage retirement income so that it is there for those monthly payments -- by, say, putting money in a low-cost and inflation-protected fixed annuity. But if you end up with lesser coverage and risk large out-of-pocket costs for medical disasters, then you would be better off leaving more of your money under your own control, so you could withdraw large chunks in an emergency.