5 health questions to ask before you’re 65

John Moye, 64, has been a healthy man for most of his life. “I didn’t really think about health care until two years ago,” he admits. When he realized he needed to prepare for the future, he turned to friends and family for advice. But on some issues, from long-term care to advance directives, his advisers were as bewildered as he was.

As you approach retirement age, you may need help making the right decisions regarding your health care. But it’s hard to get answers when you don’t know the right questions to ask. These five will get you started.

1. How much should I budget for future health care costs?

Short answer: more than you think. Research sponsored by the Mayo Clinic finds that 9 out of 10 people underestimate health care costs in retirement. Most Americans expect to spend 10 percent of their retirement budget on health care. But real costs are closer to 30 percent. The silver lining: You’re better off discovering this now than when you’re 80.

Online calculators can give you a ballpark figure of your future health care costs.  They take into account factors such as your age, height, weight and medical conditions.

For example, one tool provides an estimate for a 58-year-old woman. She has a body mass index (BMI) of 26 and a history of arthritis, high blood pressure and high cholesterol. The tool estimates she’ll spend $135,000 in out-of-pocket costs throughout her retirement. That figure drops to $94,000 for the same woman without a history of high blood pressure and high cholesterol.

Online tools like Fidelity’s are a useful first step.  But they can’t account for everything, especially chronic health conditions.

A financial planner can create a more accurate and personalized budget, as well as a realistic strategy to cover your future costs. (For instance, you may have to rethink your vacation plans or kitchen remodel.) You’ll get the most unbiased advice from a paid Certified Financial Planner (CFP).

Free or low-cost financial advice for older adults is also widely available through banks, libraries and senior centers. Just be aware that some “free” advisers earn a commission on any investments they sell you. So take their recommendations with a grain of salt.

The longer you have till retirement, of course, the more savings you can sock away. If you have the means, max out your 401(k), IRA or HSA contribution. You’ll save on taxes in the short term, and could avoid having to dip into your savings later on.

2. What’s the difference between Original Medicare and Medicare Advantage?

Original Medicare is health insurance managed through the federal government. Part A covers hospital care, and Part B covers other medical care like doctor appointments and preventive screenings. You can go to any provider that accepts Medicare. Coverage for prescription drugs (Part D) is not included. For more on parts A, B, C and D, check out Aetna’s Medicare site.

Medicare Advantage, managed by private insurance companies, includes both hospital and medical coverage. Many Medicare Advantage plans also cover prescription drugs. The most common types of Medicare Advantage plans are HMO and PPO plans. With an HMO plan, you generally must use network doctors. A PPO may cover out-of-network doctors at a higher cost.

To determine which plan may be right for you, visit the government Medicare site or Aetna Medicare site.

Aetna Medicare

Government Medicare

3. Do I need long-term care coverage?

When an older adult breaks a hip, loved ones are often alarmed. Healthy and motivated patients may return to their routine in a month or two. But others may be in recovery for up to a year or more. Long-term care insurance kicks in when you need help caring for yourself for more than 90 days. It helps cover the cost of your care in a nursing home, assisted-living facility or at home.

With assisted-living facilities charging more than $42,000 a year, long-term care insurance seems like a must. But these policies don’t come cheap: A healthy 55-year-old man will pay upwards of $2,000 a year for a policy. If you’re in your late 60s, that figure could double.

According to Money magazine, long-term care insurance is useful only if you have significant savings to protect.

Most people rely on family care or Medicare/Medicaid. Ask a financial advisor if long-term care insurance makes sense for you.

4. What are advance directives?

“Advance directives” explain your wishes about medical care to your loved ones and health team in case you’re unable to speak for yourself. Creating clear instructions ahead of time ensures your values are respected during a medical crisis or end-of-life care. A written document also lifts the burden of responsibility from loved ones, who may disagree with your wishes or each other.

You can download a form specific to your state at CaringInfo.org, a program offered by the National Hospice and Palliative Care Organization. 

And the popular Five Wishes living will ($5), from the nonprofit organization Aging with Dignity, is available in 28 languages and legally recognized in 42 states.

Learn about Five Wishes

Your advance directive will include at least one of the following:

Living will. This document describes your preferences regarding pain management, invasive surgery, artificial life support, organ or tissue donation, long-term care due to Alzheimer’s disease, and more. Make sure to keep your living will somewhere your loved ones can easily find it.

Health care proxy. Also called power of attorney. Nominate someone you trust, your “proxy,” to make decisions about your health care when you can’t and the situation isn’t covered by your living will. Talk to this person about your wishes in advance.

Do Not Resuscitate (DNR). This instructs your health care team not to perform CPR and other life-saving measures if your heart stops beating. The document can be added to your medical record.

5. I want to get healthier — but is it too late to change?

If you’re over 60, you might assume it’s too late to quit smoking, eat right and exercise. But research overwhelmingly shows that making lifestyle changes in your 60s or 70s can significantly improve your short-term wellbeing and long-term health. Even if you pride yourself on a healthy lifestyle, you may have a blind spot or two. Consider these 9 lifestyle recommendations your friendly reminders:

Know your numbers. Get regular checkups, and find out what your cholesterol and blood pressure numbers say about your overall health. Ask your doctor if your body mass index (BMI) and blood-sugar levels are healthy.

Quit smoking. Giving up smoking is one of the best things you can do for your heart. Quitters also lower their risk of cancer.

Get moving. Never exercised before? No worries. Start with walking or any activity you enjoy: bowling, gardening, dancing, biking. Even 10 minutes a day can make a difference. Learn more about how to get started.

Watch your diet. Eat more vegetables, less meat and junk food. It’s that simple.

Be careful about vitamin supplements. Some supplements do more harm than good, especially when combined with prescription medication. Your doctor can run blood tests to see which ones you really need.

Drink water. Dehydration is common among older adults. Try to drink several large glasses of plain water a day.

Wear sunscreen. As we age, our skin is less able to protect itself from UV rays. And tanning beds are no safer than the sun.

Reduce alcohol. Our bodies are less able to process alcohol as we get older. Even if you drink in moderation, consider cutting back.

Stay socially connected. Being social lowers stress levels and keeps your brain young. And spending time with people with healthy habits tends to rub off. Find out more about staying social as you age.

It all boils down to being proactive. Seek out help for your financial, legal and health care questions. Then pass it forward: Share what you’ve found with friends and family. When it comes to getting older, we’re all in this together.