It may seem counterintuitive, but if you’re healthy and enjoy a nice, long life in retirement, you’ll pay more in health care costs than your less-healthy compatriots. 

At least that’s the upshot of a new report from the Insured Retirement Institute, which analyzed data from HealthView Services and found that a 65-year-old male in excellent health will face health care expenses, including premiums, that will add up to $345,000. His less-healthy buddy, meanwhile, will only have paid around $246,000 altogether. 

Of course, the healthy guy can console himself at his buddy’s funeral with the thought that spending all that money has bought him time. He’ll likely make it to around 87, while his friend will have lived to perhaps 81. 

For women, the healthy will be dandling great-grandchildren on their knees until around age 89, while their less-healthy friends will have only been able to do that until 84. 

Now here’s the drawback. That healthy guy may have to drive from his friend’s funeral right to the breadline to come up with that night’s dinner, because he is more likely to have used up all his retirement money and is now forking over his Social Security benefit checks to pay health expenses. They might not be big expenses, but because of his age, there will have been substantially more of them to pay. 

“There’s no question that a long, healthy retirement is an overwhelmingly positive thing,” IRI President and CEO Cathy Weatherford said in a statement. “But even those in excellent health will need to finance health expenditures, and with longer lifespans, these costs will add up quite significantly.” 

The report offered a number of interesting tidbits. Among them were estimates of income replacement needs based on health status. As might be expected, someone in excellent health was thought to need less income per year because of reduced health care costs. 

A preretirement after-tax income of $100,000 for a healthy individual with no plans to engage in extensive discretionary spending after retirement, such as traveling, was estimated to need an income of $65,000 per year after retirement. On the other hand, if the poor soul is in poor health, he might need as much as $80,000 to cover likely spending on health care. 

But another consideration is this: the average person who lives to 84.1 years of age will only be healthy for 78.9 years. From that point on, he’ll likely be spending a lot more on health care — and the expenses in those 5.2 years can mean he might run out of money if he doesn’t have an increasing income stream to rely on. 

Ditto for the exceptionally healthy person, the one who could live to be 87. It’s much more likely that that healthy person could run out of money in later years because of escalating medical costs when ill health finally strikes, so careful planning is necessary to accommodate both a longer life expectancy and higher health care costs without exhausting financial resources — particularly since, the report says, “given average historic investment returns, those cumulative (health care) expenses will likely outpace the systematic withdrawal portfolio’s ability to generate sustainable income.” 

Among the potential solutions to outliving one’s income, the paper suggests evaluating the advantages of deferred income annuities, which can kick in anywhere between two to 40 years after purchase — thus providing the healthy retiree with an additional source of retirement income later when expenses have likely risen.