There’s no way around it. Retirement health-care costs must be included in our financial planning. The financial services industry has done a great job of selling us on the idea that our retirement will be great – just buy from them. We have all seen the picture of the perfect, silver-haired couple walking on the beach with the sailboat in the background. It is best to be a glass-half-full person, but too many seniors are focused on the good things expected from retirement rather than focusing on their total expense picture. Plain and simple, the majority are simply unprepared for the cost of retirement health care.

Here’s the reality. Fidelity Investments recently released its annual projection of what couples can expect to pay for medical bills throughout their retirement. The study shows that costs have increased 4 percent - $240,000 in 2012 compared with $230,000 in 2011.

The numbers are based upon a 65-year old couple retiring this year with Medicare coverage, and factor in the federal program’s premiums, co-payments and deductibles, and out-of-pocket prescription costs. It’s also assumed that the couple do not have insurance from their former employers. Life expectancy is 85 for women and 82 for men. The estimate doesn’t include the cost of long-term care, such as in a nursing home. The full study is available at

Expect to spend almost a quarter of a million dollars for health care in retirement? The majority of Americans aren’t even prepared for day-to-day retirement expenses, much less the depth of these projections. What does the future hold for these individuals?

When these monetary shortfalls become reality for millions of Americans, who will be held responsible? Will it be up to the U.S. government to bail them out? (By the way, if this is the government’s problem, it’s our problem. All government can do is control who gets coverage and then send us the bill via taxes.) Was this the employer’s fault? Or will it remain the responsibility of (gasp) the individual?

Let’s lay out some options.

• First, there is the hope that you don’t get sick and won’t incur many health-care expenses in retirement.

• The second is to pass the buck and hope the government or employer programs will be there to support your needs.

• Third is to plan on living within or below your means and take the responsibility for planning for your needs.

The answer may be to realize you can only count on yourself. Being financially fit takes a lifetime of dedicated work. Be diligent in your saving, investing and planning. Run many different scenarios that include and exclude benefits, planning for the contingencies. Retirement is a great time to explore yourself and the world without the constraints of a job. Have fun, but also have plans in your back pocket for those curveballs that life can throw your way.

Brian Hood, a certified financial planner, is a senior partner with Legacy Financial Group LLC, an Urbandale-based financial planning and education firm.