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New Update: Healthcare Costs Increasing by Over 60% in Some States. Will you be impacted?

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Health Care Costs in Retirement: What Sears Holdings Employees Need to Know and How to Prepare

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Healthcare Provider Update: Healthcare Provider for Sears Holdings Sears Holdings typically provides healthcare benefits to its employees through various insurance plans, often with national insurers such as Aetna, UnitedHealthcare, or Anthem Blue Cross Blue Shield being among the health carriers they have partnered with. The specific providers can vary by location and employee selection during open enrollment periods. Potential Healthcare Cost Increases in 2026 As we progress into 2026, the healthcare landscape is expected to face significant challenges, particularly for employees of Sears Holdings. Forecasts indicate steep premium hikes, with some states imposing increases of over 60%, largely influenced by rising medical costs and the potential expiration of enhanced ACA premium subsidies. The Kaiser Family Foundation highlights that without congressional intervention, millions of marketplace enrollees could see their out-of-pocket costs surge by more than 75%. This convergence of factors threatens to impose a substantial financial burden on both individuals and employers, necessitating proactive strategies to mitigate rising expenses. Click here to learn more

'Sears Holdings employees must recognize the importance of early health care planning, as escalating medical expenses and the need for long-term care can quickly deplete retirement savings without strategic budgeting and proactive measures like long-term care insurance and health savings accounts.' – Paul Bergeron, a representative of The Retirement Group, a division of Wealth Enhancement.

'Sears Holdings employees should prioritize health care planning as an essential part of their retirement strategy, so they can prepare for the rising costs of medical care, which can significantly impact their financial stability during retirement.' – Tyson Mavar, a representative of The Retirement Group, a division of Wealth Enhancement.

In this article, we will discuss:

  1. The importance of health care costs in retirement and the impact on retirement savings.

  2. Strategies for budgeting for health care expenses, including long-term care insurance and health savings accounts (HSAs).

  3. Tools and resources to help Sears Holdings employees plan for health care costs in retirement.

When planning for retirement, health care expenses are a critical consideration for Sears Holdings employees. While many retirees believe that Medicare will cover most of their medical bills, the reality is often quite different. Prescription drugs, long-term care, co-payments, and premiums are just some of the out-of-pocket costs that can quickly accumulate, leading to significant financial strain. Over time, these expenses could deplete your retirement savings if not adequately planned for. A thoughtful approach is required to lessen the impact of these rising costs, especially since health care costs are rising at a faster rate than inflation.

Making informed decisions requires an understanding of how lifestyle choices, family medical history, personal health, and inflation can affect health care expenses. Sears Holdings employees can safeguard their retirement savings by implementing strategies such as investing in long-term care insurance, using employer-sponsored accounts, and purchasing supplemental insurance. This article explores the importance of health care costs in retirement, ways to budget for them, and tools to help Sears Holdings employees plan ahead.

The Importance of Medical Expenses in Retirement

Sadly, Medicare doesn't cover all medical needs, and health care costs rank among the largest expenses seniors face. While Medicare covers approximately 98.2% of individuals aged 65 and older, 1  it doesn’t pay for all medical costs. A study by the Kaiser Family Foundation (KFF) found that 22% of retirees have medical debt, 2  largely due to increasing medical expenses and unexpected out-of-pocket costs. Prescription drugs, supplemental health plans, and long-term care services, such as in-home care or nursing facility stays, are common examples of these expenses. With health care costs rising faster than inflation, this can significantly reduce retirement savings, particularly for those unprepared.

As Paul Bergeron, a financial advisor with The Retirement Group, points out, 'Sears Holdings retirees unprepared for rising health care  costs can face considerable financial challenges and unexpected out-of-pocket expenses.' This makes planning for health care costs crucial, especially considering the impact of inflation, medical advancements, and longer life expectancies on future health care needs.

Budgeting for Health Care Costs in Retirement

While retirees may have little control over how quickly health care prices rise, they can take action to reduce their personal financial risk. The following strategies can help Sears Holdings employees manage health care expenses during retirement.

Long-Term Care Insurance

One of the largest medical expenses Medicare doesn't cover is non-medical long-term care. According to the 2024 Cost of Care Survey by Genworth and CareScout, the average cost of an assisted living facility is $70,800 per year, while a semi-private room in a skilled nursing facility can cost up to $111,325 annually. 3  Since 69% of individuals who reach age 65 today are expected to require long-term care at some point, 4  planning ahead is essential.

Without long-term care insurance, retirees will have to pay for these expenses out of pocket, which can rapidly deplete retirement funds. Purchasing long-term care insurance while in good health is an effective way to reduce the financial impact of these costs. The mid-50s is typically the best time to obtain this coverage. At this stage, people are typically still healthy enough to qualify for reasonable rates and have ample time to pay for the coverage before it's needed. However, premiums tend to rise as individuals age, with increases of 2-4% in their 50s and 6-8% in their 60s. Additionally, applicants over age 70 may struggle to find coverage, as 38.2% of applicants aged 65-69 and 45% of those 70 and older are typically rejected. 5

For those seeking both life insurance and long-term care coverage, buying a life insurance policy with a long-term care rider can be a cost-effective solution.

Health Savings Accounts (HSAs)

Sears Holdings employees with high-deductible health plans (HDHPs) can take advantage of health savings accounts (HSAs) to save for medical expenses on a tax-advantaged basis. HSAs offer three tax benefits: tax-deductible contributions, tax-deferred growth, and tax-free withdrawals for eligible medical expenses. 'The HSA combines the best features of a Roth IRA and a traditional IRA,' says Tyson Mavar of The Retirement Group. 'Contributions are tax-deductible, they grow tax-deferred, and withdrawals for qualified medical expenses, including Medicare premiums, are tax-free.'

Unlike other employer-sponsored accounts, HSAs do not have a 'use-it-or-lose-it' policy, meaning the funds can be carried over from year to year. Contributing to an HSA as retirement approaches can result in substantial savings for future medical costs. For 2025, the contribution limit is $8,550 for family coverage and $4,300 for individual coverage. Individuals 55 and older can contribute an additional $1,000 as a catch-up payment.

Starting an HSA early in one’s career gives ample time to build savings, but even employees in their 50s nearing retirement can benefit from contributing up to the maximum allowed.

Supplemental Insurance and Medicare

While Medicare provides basic coverage, it doesn't cover all medical expenses. For example, routine physical exams, dental, vision, and hearing treatments are not covered by Medicare. These out-of-pocket costs can quickly add up.

Medigap, or Medicare supplemental insurance, can help cover the gaps in Medicare’s coverage. These plans, offered by private insurers, cover expenses like co-payments, co-insurance, and deductibles. Medicare Advantage (Part C) plans, also offered by private insurers, combine basic Medicare with prescription coverage and include regular dental, vision, and hearing care.

By investing in Medigap or Medicare Advantage, Sears Holdings retirees can reduce the financial burden of unexpected medical costs, though both options carry additional monthly premiums.

Retiree Reimbursement Arrangements (RRAs)

Retiree reimbursement arrangements (RRAs) are employer-sponsored initiatives designed to help retirees pay for medical expenses. Sears Holdings retirees can take advantage of any available RRAs, which allow them to receive reimbursements for eligible medical expenses, such as Medicare premiums, up to a specified annual limit. Some employers even allow unused funds to roll over from year to year. Since RRAs are fully employer-funded, they provide retirees with additional financial support for health care costs.

Optimizing the use of Sears Holdings’s RRA, if any, can significantly reduce your retirement medical costs.

Telehealth Services

Telehealth, the remote delivery of medical services, is increasingly popular among retirees. It offers a convenient option for individuals who may have difficulty traveling or leaving their homes to visit a doctor. Telehealth allows retirees to manage minor health issues, prescriptions, and chronic conditions without the need for in-person visits, reducing the incidence of emergency room visits and hospitalizations. Additionally, telehealth services are often more affordable than in-person appointments, contributing to overall savings.

Sears Holdings employees should check with their health care providers or Medicare Advantage plans to learn about the telehealth services available to them, as some plans may offer enhanced telehealth benefits compared to traditional Medicare.

Preventive Care

Preventive care plays a crucial role in reducing health care costs in retirement. Regular check-ups, screenings, and vaccinations help identify health risks early, lowering the need for more expensive treatments down the road. Research shows that retirees who maintain an active lifestyle and engage in preventive care generally face lower long-term health care expenses.

Financial advisor Tyson Mavar notes, 'Eating well, exercising regulatory, and making other healthy lifestyle choices can help you save untold dollars over time.' Regular physical activity can also reduce cognitive decline, which may lower the need for long-term care in later years.

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Key Considerations When Budgeting for Health Care Costs

Creating a personalized health care budget is essential for retirees, especially Sears Holdings employees. Factors such as lifestyle, family medical history, and personal health can significantly influence health care expenses. For instance, retirees with pre-existing conditions may require more frequent doctor visits, prescriptions, and treatments, resulting in higher out-of-pocket costs. While Medicare offers coverage for those with pre-existing conditions, retirees should plan for additional expenses, such as supplemental insurance or necessary treatments.

Family medical history is another important consideration. If there is a history of chronic or serious illnesses in your family, your health care expenses may increase as you age. Conversely, if longevity runs in your family, you may need to prepare for longer-term medical care.

Finally, lifestyle choices directly affect health care costs. Retirees who maintain healthy habits, such as regular exercise and a balanced diet, are less likely to face high medical costs than those who smoke or lead a sedentary lifestyle.

Preparing for the Unexpected

Even with careful planning, unexpected medical expenses may still arise in retirement. As Scottish poet Robert Burns famously said, 'The best-laid plans often go awry,' and retirement savings are no exception. Creating an emergency fund and having backup plans in place are essential to managing unexpected medical costs.

Long-term care insurance, an emergency fund, and supplemental insurance plans such as Medigap or Medicare Advantage can all help lessen the financial impact of unforeseen health care costs.

Resources for Budgeting Health Care Costs

There are several tools and resources available to help Sears Holdings employees estimate and plan for retirement health care costs:

  • Fidelity’s Health Cost Estimator : A free tool that projects future health care expenses.

  • Medicare.gov Plan Finder : Helps compare Medicare plans based on prescription costs and coverage.

  • AARP Health Care Cost Calculator : An online tool for estimating health care expenses in retirement.

  • Financial advisors : Your financial advisor can provide you with personalized estimates and strategies for managing retirement health care costs.

Conclusion

Health care costs must be factored into any retirement plan. Rising medical expenses, inflation, and the need for long-term care can significantly impact retirement savings. By using tools such as long-term care insurance, HSAs, and supplemental Medicare plans, Sears Holdings employees can proactively plan for health care costs and safeguard their financial future in retirement. Planning for unexpected costs, such as emergencies or unanticipated medical conditions, can help preserve retirement funds throughout your lifetime.

Sources:

1. National Center for Biotechnology Information. ' Association of Medicare eligibility with access to and affordability of care amonjg older cancer survivors .' 23 Mar. 2024.

2. Kaiser Family Foundation. ' What are the Consequences of Health Care Debt Among Older Adults? ' 26 Jul 2024.

3. Genworth and CareScout. ' Genworth and CareScout Release Cost of Care Survey Results for 2024 .' 4 Mar. 2025. 

4. Administration for Community Living. ' How Much Care Will You Need? ' 18 Feb. 2020.

5. American Association for Long-Term Care Insurance. ' Nearly Half Of Oldest Long-Term Care Insurance Applicants Declined .' 

Other resources:

1. Almazora, Leo. 'Healthcare Costs Continue to Rise for Retired Seniors.'  Investment News , 8 Aug. 2024.

2. 'Planning for Healthcare Costs: How Financial Advisers Can Guide Clients.'  Kiplinger , Mar. 2025.

3. 'Retired? Here's 5 Reasons You Still Need an Emergency Fund—Plus How Much It Should Cover.'  Investopedia , 30 May 2025.

4. 'Cancer Treatments Derailed a Boomer's Retirement.'  Business Insider , 28 May 2025.

5. 'The Real Cost of Health Care in Retirement.'  RBC Wealth Management , Oct. 2024.

How does the Sears Holdings Pension Plan differentiate between normal retirement, early retirement, and late retirement options for Kmart participants? In what ways do these options influence the retirement planning process for employees of Sears Holdings, and what specific considerations should Kmart employees be aware of when choosing one of these retirement paths, particularly in relation to their vested status?

Differentiation of Retirement Options: The Sears Holdings Pension Plan offers distinct options for normal, early, and late retirement. Normal retirement is available at age 65 or after five years of plan participation, whichever is later. Early retirement can be taken from age 55 but before 65, provided the employee is vested, with benefits subject to actuarial reduction unless certain conditions are met (like having at least 90 points, which is a sum of age and years of credited service). Late retirement pertains to any retirement after the normal retirement age, with pensions recalculated to reflect the delay in benefit commencement.

Considering the frozen status of the Sears Holdings Pension Plan, how does this impact the benefits eligibility for Kmart employees, and what implications does it have for their retirement savings strategies? In what ways should current employees factor in this frozen status when evaluating their overall retirement readiness and potential alternatives outside of the company plan?

Impact of Frozen Status: The freezing of the Sears Holdings Pension Plan on January 31, 1996, means that there have been no new accruals of benefits or participants since that date. For Kmart employees, this impacts their benefits eligibility by capping the pension benefits at levels earned up to the freeze date. Employees need to consider this stagnation in benefits when planning for retirement, potentially seeking additional retirement savings avenues to bridge any shortfall.

What are the essential calculations involved in determining the retirement benefits under the Sears Holdings Pension Plan for Kmart employees? Specifically, how do the Career Average Pay and Final Average Pay formulas come into play, and what factors should employees consider when estimating their future retirement payouts?

Essential Calculations for Retirement Benefits: Pension benefits for Kmart employees under the Sears Holdings Pension Plan are calculated using either the Career Average Pay or the Final Average Pay formulas. These calculations take into account an employee's years of credited service and compensation up to the freeze date. Factors like estimated Social Security benefits and specific formulas (such as a deduction based on Social Security benefits under the Final Average Pay formula) play crucial roles in determining the final pension payout.

How can Sears Holdings employees best navigate the process of applying for benefits under the Pension Plan? What specific steps should participants take to ensure their applications are processed correctly, and what important deadlines should they be aware of to avoid any negative consequences on their retirement benefits?

Navigating the Benefits Application Process: To apply for pension benefits, employees must submit a formal application, ideally 30 to 90 days before the intended commencement date. It is crucial to ensure all personal information, including marital status and spouse details, is up-to-date to avoid delays or inaccuracies in benefit processing. Missing application deadlines can lead to postponed benefit payments or unwanted default options.

In what situations can Kmart employees expect to receive a Deferred Vested Pension, and how is the calculation for this pension affected by their previous employment and vesting service? Employees should be aware of the important factors influencing their eligibility and the steps necessary to maintain their retirement benefits after leaving the company.

Eligibility and Calculation for Deferred Vested Pension: A Deferred Vested Pension is available to employees who leave the company after becoming vested but prior to qualifying for retirement. The calculation mirrors that of a normal retirement pension, with possible early commencement reductions. Understanding the timing of benefit commencement and the potential reductions for early start is vital for planning.

How does the Sears Holdings Pension Plan address tax considerations for employees receiving both monthly payments and lump sum payments upon retirement? What tax implications should Kmart participants be aware of, particularly in relation to IRS rules for distributions and potential penalties for early withdrawal?

Tax Implications of Pension Receipt: Pension payments, whether monthly or lump sum, are subject to federal taxes. Monthly benefits are taxed as ordinary income, while lump sums might be eligible for special tax treatments or rollover options to defer taxes. It’s important for Kmart employees to consider these implications and possibly consult with a tax advisor to optimize tax liability.

What are the rights and protections afforded to Kmart participants under the Employee Retirement Income Security Act (ERISA) as they navigate their retirement benefits with the Sears Holdings Pension Plan? How can employees leverage these rights to ensure they are receiving all the benefits to which they are entitled?

ERISA Rights and Protections: Under ERISA, Kmart employees are entitled to certain rights including the ability to appeal denied benefits, access to plan information, and assurances of fair and equitable treatment of their benefits. Leveraging these protections ensures that employees receive all due benefits.

What steps should Kmart employees take to update their personal information to ensure they continue receiving their benefits without interruption, especially in the context of missing participants or uncashed checks? What resources and contacts at Sears Holdings are available to assist with these updates?

Updating Personal Information: Maintaining accurate personal information with the pension plan is crucial for uninterrupted benefit payments. Employees should promptly update changes such as address, marital status, or beneficiaries to prevent issues with benefit distributions or lost checks.

How does the process of transferring between affiliated employers impact pension benefits for Kmart employees under the Sears Holdings Pension Plan? What considerations should be taken into account concerning Credited Service and Vesting Service during such transfers, and how can employees ensure they do not lose any entitled benefits?

Impact of Transfers Between Affiliated Employers: Transferring between Sears Holdings’ affiliated employers can affect pension benefits differently depending on whether the employer participates in the pension plan. It's essential to understand how such transfers impact credited and vesting service accruals.

For Kmart employees seeking more information about their benefits under the Sears Holdings Pension Plan, what is the best way to contact company representatives? How can they effectively communicate their questions or concerns to ensure they receive accurate and timely information regarding their retirement benefits?

Contacting Plan Representatives: Kmart employees seeking clarity on their pension benefits should contact the Sears Holdings Pension Service Center. Effective communication, including prepared questions and necessary documentation, will aid in obtaining accurate and comprehensive information.

With the current political climate we are in it is important to keep up with current news and remain knowledgeable about your benefits.
Sears Holdings Corporation's pension plans were taken over by the Pension Benefit Guaranty Corporation (PBGC) following the company's bankruptcy. The two defined benefit pension plans have been frozen since 2005, meaning no new benefit accruals are added. The plans are underfunded by approximately $1.4 billion, with PBGC assuming responsibility to ensure pension payments continue. These plans cover about 90,000 participants who worked for Sears, Roebuck and Co., and Kmart Corporation. Despite the underfunding, PBGC is expected to cover the vast majority of pension benefits owed under these plans. Participants can manage their benefits and verify information through PBGC's online platform or service center.
Bankruptcy and Store Closures: Sears Holdings emerged from bankruptcy with significant store closures, reducing from nearly 700 stores to less than 25. The company has been liquidating its remaining assets and recently announced more store closures in 2024. The focus is on resolving bankruptcy-related issues and managing the liquidation process effectively (Sources: The Layoff, Yahoo Finance).
Sears Holdings offered both RSUs and stock options before its bankruptcy. RSUs vested over time, providing shares, while stock options allowed employees to buy shares at a fixed price.
Sears Holdings, now part of Transformco, has faced numerous challenges in recent years, impacting its ability to provide comprehensive employee healthcare benefits. The strategic transformations initiated since 2017 aimed to improve operational performance and liquidity, which included measures such as obtaining additional loan proceeds and real estate sales. However, the company's financial struggles and store closures have also led to significant changes in employee benefits, including healthcare. As part of its efforts to stabilize and restructure, Sears has focused on reducing outstanding debt and pension obligations, contributing almost $4 billion to its pension plan since 2005 due to prolonged low interest rates. In 2023, Transformco continued to navigate its financial challenges, which have influenced its healthcare benefits offerings. The company has aimed to maintain basic healthcare coverage for its employees despite ongoing restructuring efforts. This includes providing access to medical, dental, and vision plans, although the specifics of these benefits and any enhancements over the past years have been less prominently highlighted compared to the broader financial strategies and operational changes. The focus on financial stability and cost reduction remains critical for Transformco as it seeks to ensure the viability of its employee benefits programs amid economic uncertainties.
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For more information you can reach the plan administrator for Sears Holdings at 3333 beverly road Hoffman Estates, IL 60179; or by calling them at 1-800-697-3277.

https://www.pbgc.gov/sites/default/files/documents/sears-holdings-summary-plan-description.pdf - Page 5, https://88sears.com/documents/pension-plan-2022.pdf - Page 12, https://88sears.com/documents/pension-plan-2023.pdf - Page 15, https://88sears.com/documents/pension-plan-2024.pdf - Page 8, https://www.consultrms.com/documents/sep-2022.pdf - Page 22, https://www.revenue.alabama.gov/documents/defined-benefit-plan.pdf - Page 28, https://www.mayoclinic.org/documents/mayo-pension-plan-2023.pdf - Page 20, https://mycentralstatespension.org/documents/annual-funding-notice-2023.pdf - Page 14, https://frs.fl.gov/documents/frs-pension-plan-2023.pdf - Page 17, https://fppta.org/documents/florida-pension-issues-2024.pdf - Page 23

*Please see disclaimer for more information

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