How health care spending varies by occupation

It shouldn't be a surprise that retirees are spending the most on health care. In 2023, a 65-year-old single person may need $157,500 in after-tax savings to pay for retirement health care costs, according to a Fidelity Retiree Health Care Cost Estimate. The average 65-year-old retired couple may need $315,000.

Outside of Medicare and insurance, people can plan for retirement health expenses by opening a health savings account. Commonly referred to as an HSA, these accounts allow workers to put aside pre-tax money to spend on qualified medical expenses. The untaxed dollars may lower out-of-pocket health care costs such as copays, deductibles, and coinsurance.

Another way to plan for health care expenses is by purchasing long-term care insurance. While it has some shortfalls—and it is not a substitute for health care—it can cover expenses that health insurance will not. Services such as hiring help for bathing, dressing, or care for Alzheimer's disease may be covered by long-term care insurance.

Blue-collar workers spend fewer dollars per year on health expenses. However, it's important for blue-collar workers to have adequate health care, pay, and sick days because they tend to work longer and have worse health conditions than white-collar workers, according to a 2011 Columbia University study.

Adults who don't have adequate—or any—health insurance are three times more likely to say they haven't visited a health clinic or medical doctor in a year, according to a KFF report, The Uninsured and the ACA: A Primer - Key Facts about Health Insurance and the Uninsured amidst Changes to the Affordable Care Act.

Those stats may explain the plight of construction workers. Fewer than 43% of construction workers in the South are offered health insurance by their employer, according to the Build a Better South: Construction Working Conditions in the Southern U.S. study by the Workers Defense Project, an organization that helps low-wage, immigrant construction workers in the construction industry. What's more, 78% lacked paid sick time, the study found, making it harder to even leave work to see a doctor without risking a cut in pay. Affordability may also be a factor; even though more than 80% of the workers in the Build a Better South study reported working overtime, 36% struggled to pay for essentials such as food or rent.

According to the KFF report, "19% of uninsured adults said they delayed or did not get a needed prescription drug due to cost, compared to 14% with public coverage and 6% with private coverage."

Story editing by Ashleigh Graf. Copy editing by Tim Bruns.