Public pensions at risk worldwide: Report

John W. Schoen | @johnwschoen 

 

Steve Cole Images | Getty Images

 

The world's retirement bill is coming due—and many countries aren't ready to pay it.
That's the conclusion of a report Monday from the Organization for Economic Cooperation and Development, a Paris-based group representing the world's developed countries.
With populations aging and lifespans rising, government-supported pensions are cutting deeper into national budgets, crowding out spending on other programs and services. The added burden comes as the economies of the developed world are growing slowly, putting added pressure on the tax revenues needed to pay rising pension costs.

The solution, according to the OECD report, includes boosting retirement ages, cutting back on early retirement and providing greater incentives for workers to save for their own retirement, including automatic enrollment in private plans.
"The ongoing rapid demographic shift and the slowdown in the global economy highlight the need for continuing reforms," OECD Secretary-General Angel Gurría said. "We must communicate better the message that working longer and contributing more is the only way to get a decent income in retirement."

In the U.S., much of the debate over pension reform has centered on the national Social Security trust fund, which has enough reserves set aside to fully cover its costs until 2027. Congress has debated a series of reforms that would extend the plans solvency, including raising contributions, indexing cost of living increases and taxing benefits.

State and local pensions are in much worse financial shape. A report in September by bond credit rater Moody's Investors Services found that, despite recent gains on their investments, U.S. public pension funds don't have nearly enough money to pay what they owe current and future retirees.

In less than a decade, that shortfall has tripled to at least $2 trillion—more than half of all outstanding state and local bond debt, according to the report.



Like nearly all retirement savers, state and local pension funds got clobbered by the 2008 financial collapse. But the pension shortfall had been building well before the downturn—and has been made worse by state and local government's shortchanging annual fund contributions. New Jersey, for example, took "contribution holidays" during the Great Recession and more recently has cut payments or just skipped them altogether, Moody's said.

Without reforms, the higher cost of an aging population threatens to stifle long-term economic growth as countries are forced to borrow money to cover their public pension promises. In Japan, where an aging population is experiencing the biggest gains in longevity, public debt is now more than twice the country's gross domestic product. Despite multiple government efforts to revive growth, Japan recently slipped back into recession after two decades of economic stagnation.



To better manage the financial risk posed by again populations, OECD officials want government to better communicate that risk to investors by creating a standard, global index. The benchmark would help investors price in the added financial burden of increases in longevity that are often buried in outdated longevity tables and other actuarial statistics.

The group also proposed that governments issue "longevity bonds" to hedge the risk that public pensions come up short in covering the cost of paying out the benefits they've promised retirees.
"Capital markets could offer additional capacity for mitigating longevity risk, but the transparency, standardization and liquidity of instruments to hedge this risk need to be facilitated," the OECD said in a statement.

John W. SchoenCNBC.com Economics Reporter

IRS changes the 401(k) rules for 2015

Hailey Lee | @haileylee139

Thursday, 23 Oct 2014 | 2:40 PM ETCNBC.com

 

COMMENTSJoin the Discussion

 

Taxpayers are about to get a bit more elbow room for retirement savings. Many contribution limits for employees with tax-favored retirement savings accounts were expanded for 2015, the Internal Revenue Service said Thursday.

The maximum for contributions in the government's Thrift Savings Plan, private sector 401(k)s and other comparable programs have been raised to $18,000, up from $17,500 in 2014 and 2013. For people over 50 years old, the "catch-up contribution" threshold has been increased from $5,500 to $6,000.

"You look at the $18,000 and wonder, gee, how many people can practically get to that level?" said Joe Ready, director of Wells Fargo Institutional Retirement and Trust. But as people "progress in their careers and earnings progressively go up," it will be increasingly important for elderly investors to max out the $24,000 limit, he said.

That's the combined total investment limit for people 50 and older—$18,000 for the 401(k) plus $6,000 for catch up.

Kenishirotie | Getty Images

 

"For those over 50 years of age—a group that needs to be far more aggressive about saving—the fact that they can get $24,000 a year in contribution is a strong message for them to save at a significant rate," said Kevin Crain, Bank of America Merrill Lynch's managing director with more than 30 years of experience in the retirement industry.

"If you look back to 2009, limits on 401(k) were around $16,000. These aren't huge bumps but it's slowly incrementing upwards and it's a nice message on the opportunity and power to save," Crain said.

If a worker is investing in both an after-tax Roth TSP (where withdrawals are tax-free), as well as a pretax TSP, then the $18,000 contribution limit applies to the amalgamation of both accounts.
For small business owners and self-employed workers that invest in an SEP-IRA or a single 401(k), the 2015 annual contribution limit rises to $53,000, a jump from $52,000 in 2014.
People who max out their contributions remain a minority but that group is growing, Crain said. In general, about 15 to 20 percent of active contributors max out their contribution limit, he said.

Some programs are unchanged. For Individual Retirement Accounts, the $5,500 limit will stay the same for 2015. Annual benefits from a defined benefit plan will stay at $210,000.
The adjustments were triggered by an increase in cost-of-living expenses. The secretary of the Treasury is required to adjust limits annually to reflect cost-of-living increases.

Read MoreSocial Security benefits will increase by 1.7%

Here is the IRS's full list of pension plan adjustments for 2015.

Finding, and Battling, the Hidden Costs of 401(k) Plans

John F. Wasik

Friday, 7 Nov 2014 | 10:35 AM ETThe New York Times

Like millions of retirees who assumed their companies had taken care of them, Ronald Tussey never thought that his retirement plan might be flawed. He trusted his company so much he kept his money in his 401(k) long after he left.

Having worked as an engineer for 37 years, ultimately at ABB Inc., where he retired 11 years ago, Mr. Tussey said he never paid much attention to the fees in his retirement plan and "assumed the company was looking out for my best interests."

But after seeing a television program on the negative impact that 401(k) expenses can have on retirement savings, he hired a lawyer, who filed a class-action lawsuit in 2006 against ABB and plan administrators.

August Kryger | The New York Times

 

Ronald Tussey, whose lawsuit against a former employer became a landmark case highlighting expenses in 401(k) plans, at his home in Lake Ozark, Mo., Nov. 6, 2014.

Mr. Tussey's suit became a landmark case that highlighted the sometimes excessive expenses in 401(k) plans. The suit remains largely unresolved today, while Mr. Tussey has become an archetype of an inexperienced litigant caught up in a legal battle far more complex than he ever expected.
"I had no idea about litigation," Mr. Tussey says. "It was unbelievable."


Like many employees, Mr. Tussey, now 70, was told that his retirement plan was "free," even though middlemen were deducting expenses from his savings.
In many retirement plans, a significant amount of future retirees' funds are devoured by fees. According to a 2012 study published by the progressive think tank Demos, high 401(k) fees can drain $155,000 from an average household over a lifetime. Higher-earning households can lose even more — up to $278,000.

Growing employee resistance, resulting from a greater awareness of plan costs, has resulted in more than 30 lawsuits against 401(k) plans and employers since 2006. Seventeen have been dismissed, but these suits are time-consuming, complex and difficult to litigate. The oldest 401(k) suits, like Mr. Tussey's, have been winding through courtrooms for the last half decade.

Despite a federal requirement that plan fees be disclosed and numerous reports on 401(k) plan flaws, few employees question how much they are being charged, much less take their employers to court. As Mr. Tussey learned, time spent on legal proceedings is clearly not on a par with time spent traveling the world, working in the community or taking up a new hobby.

After more than six years of litigation, a federal court in Missouri ruled in March 2012 that ABB and its record keeper, Fidelity Investments, violated fiduciary duties to the plan and participants and were liable for $37 million.

ABB appealed part of the case, but the United States Court of Appeals for the Eighth Circuit in St. Louis this year upheld the Federal District Court judgment that $13.4 million be awarded to participants.

A $1.7 million district court judgment against Fidelity was reversed by the higher court.
Nothing, to date, has been paid to ABB 401(k) plan participants. Lawyers representing the employees want the Supreme Court to review the case.
In the meantime, though, there are lessons here for current and future retirees.

David Franklin | E+ | Getty Images

 

At the heart of the suits are a raft of obscure fees and services that few employees will be able to discern. Unless employers absorb all of the expenses, you must pay the bills for plan record-keeping, administration and fund management.
Most fund expenses not covered by employers are deducted from plan assets — the money pooled for your retirement — and show up in an "expense ratio," which is expressed as an annual percentage of what you have invested. If your plan charges 1 percent on $100,000 invested, you are paying $1,000 annually in fees.



How much is too much for 401(k) expenses? It depends on the size and complexity of the plan. The Department of Labor's fee disclosure requirement, which went into effect about two years ago, will tell you how much is being deducted from your savings, but it won't tell you if that amount is too much.

In the somewhat opaque world of 401(k) expenses, a large plan may be the best deal, but smaller plans can still offer lower expenses if employers shop around. Often only an audit by an independent fiduciary who knows how to compare similar plans can determine whether you are being overcharged.

Jerome J. Schlichter, a St. Louis lawyer who represented Mr. Tussey and plaintiffs in other 401(k) suits, said there were some common elements in plans that could indicate lofty expenses and conflicts.

Even though no extra service may be provided, record keepers may reap higher compensation just because total assets increase from year to year. This number can be hard to find and even tougher to examine. Is your plan's record-keeping fee fair? You may need an independent consultant — someone with no financial interest in the plan, funds or middlemen — to properly vet this number.
Also look at revenue sharing. This is an often complex arrangement where a fund manager "shares" some of the fees it receives from fund expenses with other service providers, such as brokers. This practice, though declining, is particularly insidious since it provides little or no value to employees. It is derisively referred to as a "kickback" by 401(k) critics.

Expenses, perhaps the largest target for 401(k) suits, can be the easiest to vet because fees can be compared across plans and funds. Does your plan charge a "retail" fund fee? It shouldn't because 401(k)'s, even small ones, have access to the lowest-cost "institutional" or exchange-traded funds, which charge as little as 0.04 percent annually.

If your fund company offers multiple "share" classes, you will also need to know if you are getting the least expensive class. To get a basic idea, compare your plan with similar 401(k)'s on Brightscope.com. You can also look up individual fund expenses on Morningstar.com.
You will also need to see what kinds of funds are in your plan. Is your employer, particularly if it's a financial services company, offering "in-house" or "proprietary" mutual funds? They may be more expensive than other funds and pose clear conflicts of interest.
And keep an eye out for unnecessary fees that may be eating up your nest egg. These include commissions, also known as "loads," 12b-1 marketing fees, insurance-related charges, "wrap" fees and transaction expenses.

Even if you are acutely attentive to financial details or can fathom the arcane language of annual plan statements like 5500 forms, this is tough. Except for fund management fees, it's not easy to spot a blatant overcharge. Mr. Schlichter has found that even in a new era of plan disclosure, most employees "are not aware of these fees and don't learn much from their plan statements."

For help, you might want to consult outside resources, like the website Personal Capital. The online money manager has a free 401(k) Fee Analyzer. It will tell you how expenses are affecting your nest egg.

The Department of Labor's website has a wealth of information on 401(k) fees and disclosure, and you can also find a breakdown of 401(k) expenses at Bankrate.com.


What if you've found that your plan is a rotten deal, but you don't want to move your money and can't get your employer to change the plan?
As Mr. Tussey knows, it may be a long, rocky road through the court system, at the end of which you may not reap a penny.

Lawyers representing employees must prove not only that plan participants were charged exorbitant fees or employers showed a clear conflict of interest, but also that employers broke federal law by breaching their fiduciary duty. That's a legal standard that says employers must do everything in their power to act prudently on behalf of workers. In the case of 401(k) plans, that means finding a reasonable selection of low-cost funds and services.
But the legal landscape may change substantially. In October, the Supreme Court agreed to hear a 401(k) fee case. If the court rules in favor of employees, the floodgates could open for more retirement plan lawsuits.

It pays to shop around for health-care plans

If you've spent more time examining holiday sales ads than your open enrollment insurance materials, you're not alone.

A new survey from Aflac found that last year, 41 percent of employees spent less than 15 minutes researching benefits options during their employers' enrollment window—compared with an average two hours deciding which TV to buy. That can be a costly mistake.

Unless you're buying a top-of-the-line $4,000 set, health care is going to be the pricier financial decision. This year, the average worker paid out $4,823 in premiums, 3 percent more than in 2013, according to the Kaiser Family Foundation. And experts say more increases are in store for the coming year, so the plan you choose can make a big difference to your bottom line.

"This is a year where employers are making a lot of changes," said Beth Umland, director of research for health and benefits at Mercer, an HR consulting firm. "If you're ever going to read your open enrollment materials, this is the year to do it."

Robyn Beck | AFP | Getty Images

 

Health Care insurance options in California.

 

Not only can consumers expect to see more premium and deductible increases, but they may also see more low-premium, high-deductible plans (often called consumer-driven health plans). There may also be surcharges for coverage of a spouse and more incentives for healthy behaviors.
Those trends mean it's smart to use open enrollment to reassess—even if you like your current plan, said Craig Rosenberg, practice leader for health and welfare benefits administration at Aon Hewitt. You might find one that's less expensive or a better fit for your health-care needs.

"Don't buy on price alone," said Rosenberg. "You may find that the plan that costs you the least to purchase ends up costing you the most, with your health-care needs." Instead, assess how you used your plan this year, and look at how the premiums, deductibles and other costs of the plan offerings add up.

Families might find that the best value requires each spouse to find coverage through their respective employers, instead of signing on for one family plan. Employers often cover a lower percentage of health-care premiums for families than they do for individuals, and some are adding on surcharges to cover a spouse who has access to health-care elsewhere, said Tracy Watts, national health-care reform leader for Mercer. The median surcharge is $100 per month.

Don't forget to look at other voluntary benefits. Experts say open enrollment might be your only chance to opt in for employer-sponsored disability insurance, or, if you're looking at one of the high-deductible plans, hospital indemnity coverage to help cover costs if you unexpectedly end up in the emergency room.

Kelli B. Grant 

Personal Finance and Consumer Spending Reporter

Nest Egg is Breaking...

BlackRock's Fink sees nest egg problems as wave of retirees loom

Katie Kramer | @Kramer_Katie

Sunday, 19 Oct 2014 | 9:00 AM ETCNBC.com

The American retirement crisis is here, said Larry Fink, the man who runs the world's largest money manager.

The CEO, chairman and co-founder of BlackRock, which had $4.3 trillion in assets under management through the end of last year—a number that surpassed the U.S. federal budget for 2014—issued a stark warning to the wave of retirees expected to draw government benefits in the coming decades. Fink believes not enough Americans have prepared for their sunset years, and it will eventually cost them and the government.

"Too many Americans are too dependent on Social Security," Fink told CNBC, contending the federal program was designed to be a backdrop to other private savings.

"To build a proper savings for retirement requires saving continuously through life," said Fink. A later start to savings, combined with Americans' increased life expectancy leaves many ill-equipped to live twenty to thirty years of retirement "in dignity."

Adam Jeffery | CNBC 

 

Larry Fink, Chairman & CEO of BlackRock

 

According the U.S. Census Bureau, 35 percent of Americans over age 65 rely entirely on Social Security's monthly benefit, and 36 percent of the general population don't save anything at all for retirement. That number rises to over 50 percent for workers under age 30.


Perhaps an even scarier number is the 80 percent of people aged 30-54 believe they will not have enough money put away from retirement, according Census Bureau data. Fink attributes this bleak condition in part to private companies' failure to inform employees about the importance of saving for retirement.

"We have to be noisier in the private sector," says Fink, whose firm employs more than 11,000 workers. "The business community is at risk for not educating their employees."
He took issue with the defined contribution model of retirement savings, which places the responsibility for accruing savings on employees.


"Each individual tend(s) to live their life more for today than in the future," Fink said. "Saving for a thirty to forty year outcome is not a front and center priority," he said, when the cost of housing and private education is on the rise.

However, Fink argued it's a problem that cannot be ignored. He believes a long-term investment and savings strategy is the surest way to avoid the fear of not having enough and build a proper nest egg.
"One of the fundamental problems with individuals is they watch the news—whether it's Ebola, whether it's the volatility in the world, whether it's ISIS—they become frightened, and they pull back their investments to, maybe, more in cash," Fink said.

That conservatism, combined with large swaths of the public that don't invest in the first place, may mean missing out on long-term earnings for a nest egg.

"If you believe that the U.S. is the best place to invest over 40 years," Fink said. "You're probably going to be able to assume 6 to 8 percent compounding rate over a long time, owning equities."

Katie KramerCNBC Producer, "On the Money"

Overlooked health-care costs can destroy retirement planning

Shelly K. Schwartz, Special to CNBC.com

Monday, 4 Nov 2013 | 8:00 AM ET

Jill Fromer | E+ | Getty Images

 

It's not inflation or even market performance that presents the biggest risk to your retirement plan. It's unexpected medical expenses.

Indeed, health-care costs are often overlooked—or underestimated—by pre-retirees who are putting money away.
"As we age and live longer, our health deteriorates pretty heavily in the last five to seven years of life, and that's when we spend a ton of money," said Bob FitzSimmons, certified financial planner and president of Bob FitzSimmons Inc., a wealth management firm.

"I have quite a few clients who have burned through their capital in assisted-living facilities, spending $200,000 to $300,000. Generally, it's the adult children who have to come to the rescue."

According to the Employee Benefit Research Institute (EBRI), a 65-year-old couple with median prescription-drug expenses who retire this year will need $295,000 to enjoy a 75 percent chance of being able to pay all their remaining lifetime medical bills, and $360,000 to have a 90 percent chance.
Those figures factor in the premiums for Medigap and Medicare Part D outpatient drug benefits to supplement basic Medicare, along with out-of-pocket expenses for prescription drugs. They do not include the cost of nursing homes or long-term care insurance. 

A 2013 study by Fidelity Investments, however, found that 48 percent of respondents, ages 55 to 65, believe they will need just $50,000 to pay for health-care costs in retirement.

Many assume that Medicare, the federal health-insurance program for those 65 and older, will cover the rest. Not so, financial experts say.


According to EBRI, Medicare currently covers only 62 percent of the expenses associated with health-care services. And seniors can expect to pay a greater share of their costs, as Medicare limits coverage and employment-based retiree health programs disappear.


"There's a huge gap between what people are planning for and what they will actually need to pay out of pocket," said Laura Bos, vice president of financial security, education and outreach at AARP. "It can be quite the sticker shock."

Make projections: The best way to ensure that future health-care costs don't consume your savings is to determine within a reasonable degree of accuracy how much you may need, financial advisors say.
That figure fluctuates, based on your current health, lifestyle and family history. It also varies depending on who's crunching the numbers.


Fidelity Investments, for example, estimates a 65-year-old couple retiring this year will need roughly $220,000 to cover medical expenses, not including long-term care insurance throughout retirement. This is slightly less than EBRI projects.


"Start with an estimate for the national average and then take a look at your family history," said Donald Roy, a certified financial planner with New England Wealth Advisors. "Maybe your mom ended up being diabetic late in life, or your dad has a history of heart problems. Some people are more exposed to health risks than others."


Financial advisors frequently have access to tools that provide a health-adjusted life expectancy. But you can estimate that number on your own using the age-based life expectancy calculator from the Social Security Administration, adjusting the result to account for personal health history.

Invest for growth: You should also earmark a separate account for retirement savings and invest those dollars for growth, FitzSimmons said.


"That can be difficult for retirees who worry that they may not have the time horizon to ride out a crisis like we saw in 2008," he said. "They won't let themselves take on risk, but that's your best protection against rising costs."


Unless your savings are sufficient to cover projected health-care costs, FitzSimmons said, the bigger risk is being too conservative with your portfolio.

Indeed, PricewaterhouseCoopers Health Research Institute reports the health-care cost inflation rate is projected to be 6.5 percent in 2014, down from 7.5 percent this year.

Thus, the traditional safe-haven investments favored by retirees, such as money market funds and Treasurys, which currently yield less than 4 percent, would fail to keep up with health-care inflation. That's a guaranteed loss of purchasing power.

Medigap: Medigap supplemental insurance, sold by private insurance companies, can also help cover some of the health-care costs not paid by Medicare, such as copayments and deductibles. According to AARP, Medicare beneficiaries spend an average of $4,600 a year out of pocket.

To purchase a Medigap policy, you must have Medicare Part A and Part B. Medigap rates vary widely but can cost up to $175 per month, which you pay in addition to the premium for Medicare Part B. (The average Part B monthly premium is $104.90, according to Medicare.)

Keep in mind, however, that Medigap does not cover everything. It excludes long-term care insurance, vision and dental care, hearing aids, eyeglasses and private duty nursing.

Long-term care insurance: You can create an additional financial safety net with long-term care insurance. Such policies are designed to cover long-term services and support, including assisted living, home care, adult day care and hospice—things traditional health insurance doesn't cover.

"Long-term care services can cost hundreds of thousands of dollars, so long-term care insurance is certainly something to consider," said AARP's Bos.

Not everyone requires assisted living in their later years, however, and long-term care coverage does not come cheap.


As such, it's important to consider how much money you already have set aside for health-care costs and purchase only the amount of coverage you actually need, according to the Department of Health and Human Services.


You may have enough income, for example, to pay a portion of future costs and purchase only a small policy to cover the balance.

Make sure, too, that you can afford the policy payments over time as your monthly income changes, HHS advises.


If you do plan to buy, don't wait too long.


When you start having health problems, health insurance companies may deny you coverage for long-term care coverage, financial experts say. You also will pay increasingly higher premiums as you grow older.


The LTC insurance calculator provided by Genworth Financial shows that annual premiums for a 50-year-old female are roughly $1,636, but $3,657 for a female age 65.

Health savings accounts: If you're still earning a paycheck, and your employer offers a high-deductible health plan, you are also eligible to establish a health savings account (HSA).

HSAs are funded with pretax dollars, the earnings grow tax-free and your withdrawals are tax-free, if used for qualifying medical expenses. Any money you accumulate in the HSA can be used as needed, or saved to help offset future medical expenses during retirement.


The account is also portable, meaning it comes with you if you change employers or quit your job.

"I always ask my clients what they have available at work by way of health insurance, and if they have an HSA, we try to utilize it," Roy said. "The tax deductions help and if it does build some value down the road, they can use it to support some of those medical costs in retirement."

There are limits, however, to how much you can contribute each year to an HSA. In 2013, individuals can save up to $3,250 and families can save $6,450. Those 55 and older can save an extra $1,000.


Don't retire too early: The other big factor that impacts your ability to meet future medical expenses is the age at which you retire.

Those who quit their job before they are eligible for Medicare at age 65 typically have to purchase private health insurance to bridge the gap.

That can amount to $15,000 a year or more, said Roy, which can quickly deplete the savings you reserved for health-care costs.


An early retirement, he noted, also deprives you of those crucial extra years to sock money away.

A 60-year-old with a 401(k) that's worth $500,000 and earns 7.5 percent interest a year, for example, could grow his or her nest egg an additional 66 percent, to $832,392, by continuing to make the maximum monthly contribution for five more years, said Roy.

"People are often shocked when they figure out what private health insurance will cost them," he said. "They don't always have a good understanding of how much their employer is subsidizing."

Unexpected medical costs can derail your retirement plan faster than you can say "hip replacement."


The best way to avoid a savings shortfall is to plan ahead, invest for growth and use supplemental insurance, where appropriate, to pick up where Medicare leaves off, experts say.

"Planning for health-care costs in retirement is critical," Bos said. "Sit down, run the numbers and have a realistic picture of what it's going to cost you."


—By Shelly K. Schwartz Special to CNBC.com

Older Americans are ill-prepared for hefty health-care costs: Study

Kelley Holland | @KKelleyHolland

Wednesday, 15 Oct 2014 | 7:01 AM ET CNBC.com

Pali Rao | E+ | Getty Images 

Older Americans are increasingly worried about the health-care costs in their future, but few are taking steps in response.

That's the finding of a study released Wednesday by Ameriprise Financial, which found that 53 percent of baby boomers say they are "very concerned" about health-care costs in retirement.
They have reason to worry: a couple, both aged 65 and with typical prescription drug expenses, would need to have $255,000 in health-care savings to be 90 percent certain they can cover their expenses, according to the Employee Benefit Research Institute, or EBRI.
Even so, only 19 percent of the survey respondents said they were taking steps to prepare financially for their health-care costs in retirement.

There are a few bright spots for boomers facing retirement. EBRI's projections of health-care costs for retirees have fallen for two years in a row, for one thing. And while only 21 percent of the respondents in Ameriprise's new survey have purchased long-term care insurance, that figure is up from 13 percent a year earlier.


Pat O'Connell, executive vice president at Ameriprise, said he is encouraged that 88 percent of the survey respondents are aware that healthy lifestyle choices now will impact both their quality of life and financial well-being in retirement.
It is reasonable to look at the survey results "as a freight train bearing down on people," he said. "But to me, it would be a freight train you can do something about and get out of the way. People are thinking about doing something proactive."
Boomers have also gotten better at predicting their likely health-care costs in retirement, O'Connell said. "There is more coverage related to all issues of health care," he said, and for boomers in or near retirement, "this issue is becoming more and more relevant to them each year."

Carolyn McClanahan, a financial planner and former emergency medicine doctor in Jacksonville, Florida, said she takes her clients through a four-step process to help them prepare for health-care costs in retirement.

First, she has them determine what kind of health-care consumer they are. If they rarely visit the doctor and are in generally good health, they are likely to need less in health-care savings than if they go in for every hangnail and take a lot of prescription drugs.

McClanahan also encourages her clients to become empowered health-care consumers. When their doctors are prescribing tests, she teaches them to ask what the tests may show and whether the findings would change the treatment plan.
Advanced directives are McClanahan's third recommendation. (In the Ameriprise survey, only 32 percent of the respondents had such directives.) Usually when new clients come to her, they have not made their end-of-life wishes clear to their families; but now all but one of her clients has an advanced directive in place describing what they do and don't want doctors to do.
Without an advanced directive, "the default is to do everything, and everything is expensive," she said.

Fourth, McClanahan encourages clients to do what they can to take care of their health now.

McClanahan also discusses with her clients the advantages of working later in life. "Maintaining your human capital is the most important thing you can do to take care of your health," she said.
Continued employment may also let people continue with employer-sponsored health insurance. Given how little boomers are saving for health care, that's a prescription many of them may need.