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Charting Hidden Medical Costs: Essential Insights for University of Missouri Employees

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“For University of Missouri employees approaching retirement, proactively incorporating a 10–15% buffer for less-obvious medical expenses—such as prescription gaps, out-of-network care, and concierge fees—can help preserve long-term financial stability.”– Wesley Boudreaux, a representative of The Retirement Group, a division of Wealth Enhancement.

“University of Missouri employees can strengthen their retirement preparedness by using health savings accounts, annual supplemental plan reviews, and strategic budgeting to cover prescription, out-of-network, and concierge medicine costs.”– Patrick Ray, senior financial advisor at The Retirement Group, a division of Wealth Enhancement.

In this article we will discuss:

  1. The rising costs of prescription drugs

  2. Challenges of care accessibility in secondary homes

  3. The impact of concierge medicine memberships

Among the biggest and most erratic retirement expenses are health care expenditures. For University of Missouri employees approaching or in retirement, these costs can pose unique planning challenges. According to Fidelity Investments, a retired couple will spend about $330,000 on health care during their retirement—or $165,000 per individual. 1  However, this estimate frequently ignores a number of important spending categories that can raise lifetime medical costs by tens of thousands of dollars.

Costs of Prescription Drugs

Although many prescription drugs are covered by Medicare Part D, out-of-pocket costs can mount quickly for University of Missouri retirees. Known as “donut holes,” coverage gaps could expose beneficiaries to the full cost of specific therapies. Without complete insurance, specialty drugs—especially those used to treat long-term illnesses like multiple sclerosis or rheumatoid arthritis—can cost more than $5,000 a month. 2  Depending on formulary tiers and supplementary plan designs, seniors who take multiple prescriptions may have annual drug expenses ranging from $2,000 to over $10,000. 3

Care Accessibility in Secondary Homes

Medicare Advantage plans sometimes limit coverage to a single geographic service region, yet many University of Missouri retirees divide their time between primary and seasonal residences. If a retiree spends summers near family in another state or winters in warmer locations, their plan’s provider networks may not cross state lines. Regular specialists or emergency services rendered outside the network may therefore be charged at full fees—often thousands of dollars per incident. A single out-of-network emergency department visit, for instance, may cost more than $2,500 before any insurance reimbursement. 4

Memberships for Concierge Medicine

Over the past five years, seniors seeking quick access to doctors have increased their use of concierge medicine. Depending on the degree of access and services offered, annual fees for these individualized practices average between $2,000 to $5,000 per person. 5  Concierge care can improve continuity and reduce wait times, but neither Medicare nor most employer-sponsored retiree plans cover these fees, making them an extra ongoing cost that may need to be factored into a retirement budget.

The Value of Thorough Planning

According to Wealth Enhancement senior financial advisor Patrick Ray, “standard retirement forecasts often fail to capture the cumulative impact of these less-visible costs.” He notes that patients often show astonishment when their medical expenses surpass initial estimates by as much as 15% to 20%. University of Missouri staff can reduce the risk of early asset depletion by building a cautious buffer into long-term income strategies—adding 10% to 15% to expected yearly medical expenses.

Techniques for Mitigating Risk

To help maintain financial stability in retirement, University of Missouri employees should:

  • Compare Supplemental Plans Every Year:  Review Medicare Supplement (Medigap) products and Part D formularies each autumn to obtain the best coverage and costs.

  • Use Health Savings Accounts (HSAs):  If you have an HSA balance upon retiring, these tax-advantaged funds can cover qualified medical expenses—including premiums for long-term care insurance—tax-free.

  • Plan for Travel-Related Care:  Consider multi-state or national network plans, such as certain Medicare Advantage PPO options, to keep out-of-pocket costs lower when spending time away from your primary residence.

  • Examine Concierge Options Carefully:  Before enrolling, estimate how many enhanced services you’ll actually use to decide whether membership fees are worthwhile.

Retirement health care expenditures are not only significant but also highly unpredictable. By identifying and budgeting for prescription medication gaps, out-of-network services, and concierge fees, University of Missouri retirees can preserve their financial resources and maintain control over their medical decisions.

Learn how to make the most of HSAs, compare supplemental plans annually, and safeguard savings from rising medical bills. You can also uncover hidden retirement health care costs, such as Medicare Part D prescription gaps, out-of-network expenses in secondary residences, and concierge medicine fees—all critical areas for University of Missouri employees to consider.

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Sources:

1. Fidelity Investments. ' Fidelity Investments Releases 2024 Retiree Health Care Cost Estimate as Americans Seek Clarity Around Medicare Selection .' 8 Aug. 2024. 

2. MedCity News. ' Managing the Specialty Drug Cost Challenge: Is Your Pharmacy Benefits Strategy Ready for 2025? ' by Stanley Crittenden. 19 Nov. 2024. 

3. USA Today. ' Medicare caps seniors drug expenses: What you need to know ,' by Ken Alltucker. 7 Jan. 2025. 

4. GoodRx. ' Using the ER for Non-Emergencies Is Expensive - Here Are Other Options ,' by Geoff Williams. 23 Mar. 2023.

5. PartnerMD. ' Concierge Medicine Costs: What You'll Pay and What to Expect ,' by Melissa Gifford. 1 May 2025.

Other Resources:

1. Centers for Medicare & Medicaid Services.  Understanding Medicare Advantage Plans . Publication no. 12026, 19 Feb. 2025,  www.cms.gov/Medicare/Health-Plans/MedicareAdvtgSpecRateStats/downloads/12026-stateavgadj2010.pdf .

2. Hallie Levine. “What to Know About Concierge Medicine.”  AARP , 15 Apr. 2019,  www.aarp.org/health/medicare-insurance/info-2019/concierge-medicine.html .

3. Internal Revenue Service.  Publication 969: Health Savings Accounts and Other Tax-Favored Health Plans . 19 Jan. 2025,  www.irs.gov/pub/irs-pdf/p969.pdf .

4. Kaiser Health News. “Doughnut Hole Is Gone, But Medicare’s Uncapped Drug Costs Still Bite into Budgets.”  Kaiser Family Foundation , 17 Jan. 2018,  www.kff.org/medicare/issue-brief/doughnut-hole-is-gone-but-medicares-uncapped-drug-costs-still-bite-into-budgets/ .

5. Trish, Erin, and Sean Dickson. “National Health Expenditures in 2023: Faster Growth As Insurance Coverage Expands.”  Health Affairs , 5 Dec. 2024,  www.healthaffairs.org/content/forefront/national-health-expenditures-in-2023-faster-growth-as-insurance-coverage-expands .

How does the eligibility criteria for the Defined Benefit Retirement Plan at the University of Missouri System differ for Level One and Level Two members, particularly in regard to their hire or rehire dates?

Eligibility Criteria for Level One and Level Two Members: Level One members are employees hired before October 1, 2012, or those rehired before October 1, 2019, who had earned a vested benefit but did not receive a lump sum. Level Two members are those hired or rehired between October 1, 2012, and October 1, 2019, without eligibility for Level One benefits. Employees hired after October 1, 2019, do not accrue service credit under the DB Plan​(University of Missouri …).

In what ways do service credits accumulated at the University of Missouri System impact an employee's retirement benefits, and how can employees ensure that they effectively maximize their service credit over the years?

Impact of Service Credits on Retirement Benefits: Service credits are critical in calculating retirement benefits at the University of Missouri System. Employees accumulate service credits based on their years of service, which directly affect their pension calculations. Maximizing service credits involves consistent full-time employment without breaks, as any leave of absence or part-time status may impact the total service credits earned​(University of Missouri …)​(University of Missouri …).

What are the various options available to employees at the University of Missouri System for receiving their retirement benefits upon reaching normal retirement age, and how do these options influence long-term financial planning for retirement?

Retirement Benefit Options: Upon reaching normal retirement age, employees can choose between a Single Life Annuity or a Joint and Survivor Annuity, both with options for lump-sum payments of 10%, 20%, or 30% of the actuarial present value. These choices influence monthly payout amounts, and selecting a lump sum reduces future monthly benefits proportionally​(University of Missouri …).

With respect to the University of Missouri System's Defined Benefit Plan, how are employees' contributions structured, and what implications does this have for their overall retirement savings strategy?

Employee Contributions: Employees contribute 1% of their salary up to $50,000 and 2% for earnings beyond that threshold. This structure helps fund the DB Plan, with the University covering the majority of the cost. Employees need to factor in these contributions as part of their overall retirement savings strategy​(University of Missouri …).

How can employees at the University of Missouri System assess their eligibility for early retirement benefits, and what considerations should be taken into account when planning for an early retirement?

Early Retirement Eligibility: Employees may retire early if they meet specific criteria: at least 10 years of service credit for ages 55–60 or at least 5 years of service credit for ages 60–65. Early retirees will receive a reduced benefit to account for the longer payout period​(University of Missouri …).

What tax implications should employees of the University of Missouri System be aware of when it comes to distributions from their retirement plans, and how can they effectively navigate these implications?

Tax Implications of Retirement Plan Distributions: Distributions from the University of Missouri System’s DB Plan are subject to federal taxes. Employees can mitigate tax burdens by electing to roll over lump-sum distributions to a qualified retirement account, such as an IRA, to avoid immediate tax liability​(University of Missouri …).

What are the policies regarding the continuation of benefits for employees who leave the University of Missouri System, particularly for those who are not vested or are classified as non-vested members?

Non-Vested Employee Policies: Employees who leave the University before vesting in the DB Plan (fewer than 5 years of service) are not eligible for retirement benefits but can receive a refund of their contributions. These non-vested employees must decide whether to receive their refunded contributions as a lump sum or through a rollover to another retirement account​(University of Missouri …).

How might changes in employment status, such as taking a leave of absence or returning to work after a break, affect the service credit calculation for an employee at the University of Missouri System?

Impact of Employment Status Changes on Service Credit: Employees who take leaves of absence or return after breaks in employment may experience reductions in service credit. However, certain types of leave, such as military service or medical leave, may allow employees to continue earning service credit​(University of Missouri …)​(University of Missouri …).

In the event of an employee's death prior to retirement, what benefits are available to their survivors under the University of Missouri System's Defined Benefit Plan, and how can members ensure their wishes are respected?

Survivor Benefits: In the event of an employee’s death before retirement, survivors may be eligible for either a lump sum or monthly payments. Employees can designate beneficiaries to ensure that their wishes are honored, providing financial protection for dependents​(University of Missouri …).

How can an employee at the University of Missouri System contact the Human Resources Service Center to obtain personalized assistance regarding their retirement options and any inquiries related to their retirement plan details? These questions require detailed answers and are designed to facilitate a comprehensive understanding of retirement processes and options for employees of the University of Missouri System.

Contacting HR for Assistance: Employees can contact the Human Resources Service Center for personalized assistance regarding their retirement options by emailing hrservicecenter@umsystem.edu or visiting the myHR portal for further details​(University of Missouri …).

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