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Health Care Costs in Retirement: What Duke Energy Employees Need to Know and How to Prepare

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'Duke Energy 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.

'Duke Energy 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 Duke Energy employees plan for health care costs in retirement.

When planning for retirement, health care expenses are a critical consideration for Duke Energy 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. Duke Energy 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 Duke Energy 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, 'Duke Energy 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 Duke Energy 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)

Duke Energy 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, Duke Energy 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. Duke Energy 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 Duke Energy’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.

Duke Energy 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 Duke Energy 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 Duke Energy 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, Duke Energy 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 Duke Employees' Retirement Plan calculate benefits at normal retirement age, specifically for employees who reach the age of 65? In what circumstances might an employee consider retiring before reaching this age, and how would the benefits differ if they choose this option?

Benefit Calculation at Normal Retirement Age: Duke Employees' Retirement Plan calculates benefits for employees who retire at age 65 by applying a formula that includes 1.25% of their average final compensation for the first 20 years of credited service and 1.66% for any additional years. If an employee retires before 65, they can do so after age 45 with 15 years of service, but their benefits will be reduced based on how early they retire, resulting in lower payments due to a longer payout period.

What considerations should an employee keep in mind regarding their unused sick leave or carry-over bank hours when calculating benefits under the Duke Employees’ Retirement Plan? How does Duke utilize these factors to enhance an employee's credited service for the purpose of benefit calculation?

Impact of Unused Sick Leave and Carry-Over Bank Hours: Unused sick leave and carry-over bank hours are converted into additional credited service, which can enhance the calculation of retirement benefits. Employees who have accumulated these hours can see their credited service extended, leading to higher pension benefits at retirement.

In what situations would an employee's benefits under the Duke Employees' Retirement Plan be automatically paid in a lump sum? How does the Plan determine the value of benefits that fall below the threshold for monthly payouts, and what implications does this have for retirement planning?

Lump-Sum Payments for Small Benefits: If the value of an employee's benefit is $5,000 or less, Duke Employees' Retirement Plan automatically pays it as a lump sum. For benefits between $5,000 and $10,000, employees can choose between a lump-sum payment or a monthly pension. This can significantly impact retirement planning, especially for employees weighing whether to take a smaller upfront amount or spread it over time.

How does the Duke Employees' Retirement Plan handle benefit adjustments for employees who continue to work beyond their normal retirement age? What factors influence how these adjustments are calculated, and what implications might this have for future financial planning for employees nearing retirement?

Benefit Adjustments for Postponed Retirement: Employees who continue working beyond their normal retirement date will see their benefits increased annually (by no less than 10%) to account for the shorter period during which they will receive payments. The plan recalculates benefits based on the employee’s continued service and compensation after age 65.

What options are available to employees of Duke University regarding payment forms when they retire, and what are the long-term implications of choosing each option? How do these choices affect both the retiree's monthly income and survivor benefits for a spouse or other beneficiary?

Payment Form Options and Implications: At retirement, employees can choose various payment options such as a single life annuity, joint and survivor annuities, or a lump-sum payment. These choices affect the amount received monthly and any survivor benefits for a spouse or beneficiary. Employees should carefully consider their long-term financial needs and the needs of their beneficiaries when selecting a payment option.

What specific protections does the Duke Employees' Retirement Plan provide for spouses in the event of an employee's death, and how does this influence the choice of payment options? What steps must an employee take to ensure that their spouse's rights are upheld under the Plan?

Spousal Protections: The Plan provides protections for spouses in the event of an employee's death. A surviving spouse can receive 50% of the employee's reduced monthly benefit through a joint and survivor annuity. Employees must take steps to ensure spousal rights are protected by selecting the appropriate payment option and ensuring the necessary documentation is completed.

How can employees of Duke University ensure that they are informed about their rights under ERISA while participating in the Employees' Retirement Plan? What resources and tools does Duke provide to help employees understand and assert these rights?

Employee Rights Under ERISA: Duke provides resources for employees to understand their rights under ERISA, including access to plan documents and assistance in filing claims. Employees are encouraged to use Duke's available tools to assert their rights and ensure they are fully informed about the benefits available to them under the Plan.

In what ways can employees at Duke University navigate the complexities of reemployment after retirement, and how does their choice of retiree status affect their benefits? What regulations govern how benefits are recalculated if they choose to return to work at Duke?

Reemployment After Retirement: Employees who return to work at Duke after retiring can continue to receive their pension if they work fewer than 1,000 hours per year. However, if they exceed 1,000 hours, their payments will be paused and recalculated based on additional service and earnings when they retire again. This provides flexibility for employees considering reemployment after retirement.

What impact do legislative changes, such as those introduced by the IRS, have on the Duke Employees' Retirement Plan’s structure and benefits? How should employees approach understanding these changes in the context of their personal retirement strategies?

Impact of Legislative Changes: Changes introduced by the IRS or other regulatory bodies can impact the structure of the Duke Employees' Retirement Plan and its benefits. Employees should stay informed about these changes and how they affect personal retirement strategies, particularly regarding tax laws and pension calculations.

How can employees at Duke University contact the Retirement Board for questions or clarifications regarding their retirement benefits? What is the best approach for reaching out to ensure that they receive timely and accurate information?

Contacting the Retirement Board: Employees can contact Duke's Retirement Board for any questions or clarifications regarding their retirement benefits. The Retirement Board is responsible for managing the Plan, and employees are encouraged to reach out directly for timely and accurate information to address any concerns about their retirement.

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For more information you can reach the plan administrator for Duke Energy at 550 S Tryon St Charlotte, NC 28202; or by calling them at (800) 777-9898.

*Please see disclaimer for more information

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