This is the period when many people catch up financially for their retirement years. To do that you need to segregate your children’s medical, care, and wellness costs from yours and your spouse’s to get a good baseline on the total cost of the services you use now. Because employers absorb many of the costs, they can get taken for granted.

a) Total your medical, health, and wellness costs for the year.

b) Add any costs your employer pays for medical, care, and wellness benefits that you and your spouse want to access – throughout retirement.

That provides a perspective on what it takes to maintain your health now, and how that relates to your total retirement income. Those costs will increase as you age. (See section above on costs of medical and care support.) Medicare helps but will not do it all.

Medicare provides medical services. The mix and cost depend on how you participate. You don’t need to choose now, but none are free. Medicaid provides the nursing services, home health services, and depending on the state, optional services like dental, vision, or transportation that Medicare does not. The trade-off to qualify for the Medicaid safety net is a cap for income and assets.

The objective is to understand the size of the gap Medicare leaves, what that means for a surviving spouse, how it relates to your assets, and what it means for any legacy you want to leave your children.

Then determine how you are going to close it, insure for it, or protect your assets in the event you need to use Medicaid. All three of those require your action many years in advance.