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Healthy couples retiring in 2019 will have to dig deep to cover medical expenses. A 65-year-old couple in good health will need $387,644 to pay for health-care costs for the remainder of their lives, according to HealthView Services, a provider of health-care cost projection software. That sum includes premiums for Medicare Part B (medical insurance) and D (prescription drug coverage), dental insurance and out-of-pocket costs related to doctor's exams, hearing services and more. The estimate excludes long-term care expenses. Here's the kicker: The healthier you are, the more money you'll spend over your lifetime, due to your increased life expectancy.

A 55-year-old woman in good health will spend an average of $13,165 in annual medical costs at age 65, HealthView Services found. Meanwhile, a woman who's the same age but is also a Type 2 diabetic can expect to spend an average of $16,635 in yearly health-care costs. Over time the healthy retiree will pay $424,875 for medical costs, while the diabetic, with the lower life expectancy, will pony up $266,163, the software provider found. "Annually, the healthy person will spend less out of pocket, but over the course of their lifetime, they will spend more because they have additional years of expenses," said Michael Daley, product marketing manager at HealthView Services.

Surprise outlays

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A major misconception among retirees is that merely having Medicare coverage will keep them from shouldering large health-care costs. "There are significant expenses that people can incur for services that aren't covered by the program," said Tricia Neuman, director of the Kaiser Family Foundation's program on Medicare policy. Those expenses include the cost of assisted living. The annual national median cost of staying at an assisted living facility hit $48,000 in 2018, according to Genworth Financial. Dental care is another blind spot for retirees, as original Medicare doesn't cover this expense.

Nearly 2 out of 3 Medicare beneficiaries — close to 37 million people — don't have dental coverage, according to the Kaiser Family Foundation. Those who do have coverage get it through private Medicare Advantage plans, Medicaid and private plans, according to Kaiser. About 20% of Medicare beneficiaries who received dental services spent more than $1,000 in 2016, Kaiser found. "Some dental services are inexpensive, like cleanings and annual checkups," said Neuman. "But some are expensive, like crowns and implants."

Nipping out-of-pocket costs

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