wealth management

Retirement isn’t the only thing workers have trouble saving for; the other big gap in planning is health care.

According to a Voya Financial survey, Americans just aren’t ready to pay for the health care they might need in retirement. Their estimates of what they might need are low—when they estimate them at all, that is—and their savings are even lower.

With worries over money woes keeping people up at night—so says a CreditCards.com poll—the only worry that surpassed “having enough saved for retirement” was “health care and insurance.”

And consider, if you will, all the turmoil in the health insurance market these days, what with potential changes to—or an outright repeal of—the Affordable Care Act waiting in the wings, not to mention the skyrocketing costs of both care and coverage.

In light of all this uncertainty, it’s no wonder that the little matter of paying for health care is keeping people awake.

But, considering all that, it’s even more surprising that there are so many common misconceptions about health care, its cost and how to pay for it at large in the general population.

American workers are not just ill prepared for retirement, they’re even more ill prepared for any illness or infirmity that may come along with it.

According to research from the Employee Benefit Research Institute (EBRI), a 65-year-old man would need $127,000 in savings while a 65-year-old woman would need $143,000—thanks to a longer projected lifespan—to give each of them a 90 percent chance of having enough savings to cover health care expenses in retirement.

But that doesn’t appear to have filtered its way down to U.S. workers, who are blissfully (well, maybe not so blissfully) ignorant of the mountain of bills that probably lies ahead.

While demographics play a role, there are smaller differences among some groups than one might otherwise expect. In addition, it’s also rather surprising where Americans plan to get the money to pay for whatever care they receive, and how far they think that money will stretch when it also has to pay for food, clothing, shelter and any activities or other necessities that come along with retirement.

Read on to see 10 misconceptions workers have about how and how much they think they’ll pay for medical care in retirement. As you’ll see, some generations are more prone to certain errors than others.

10. Workers just aren’t estimating how much health care will cost them in retirement.

Perhaps they’d rather not know—but according to the poll, 81 percent of Americans have not estimated the total amount health care will cost them in retirement; among them are 77 percent of boomers. Retirees haven’t estimated those costs, either; in fact, just 21 percent of them have. But that’s actually not that bad, when considering that among Americans overall, only 14 percent have actually done—or tried to do—the math.

And among those who have tried to calculate the cost, 66 percent put them at $100,000 or less while an astonishing 31 percent estimated just $25,000 or less.

9. People with just a high school education or less, and whites, are slightly more likely than those who went to college, and blacks, to have attempted to figure it out.

The great majority among all those demographic groups just aren’t looking at the numbers, with 88 percent of black respondents and 79 percent of white respondents saying they have not estimated how much money it will take to pay their medical costs throughout retirement.

And while 80 percent of those with a high school diploma or less say they haven’t run the numbers, those who spent more time in school have spent even less time doing the calculations—with 81 percent of those with some college and 82 percent of those who graduated college saying they have not estimated medical costs.

8. Millennials are the most likely to underestimate health care costs in retirement.

A whopping 74 percent of millennials are among those lowballing what they expect to spend on health care once they retire, figuring they won’t need more than $100,000—and possibly less.

Not that they really know; 85 percent haven’t actually tried to calculate their total health care expenses for retirement. But they must be believers in the amazing stretching dollar, with 42 percent planning to use general retirement savings as the primary means of paying for health expenses in retirement, excluding Medicare.

GenXers, by the way, were the most likely to guess correctly that the bill will probably be higher than $100,000—but even there, only 28 percent said so.

7. They have surprisingly unrealistic expectations about where they’ll get the money to pay for medical care.

Excluding Medicare, 34 percent intend to use their general retirement savings, such as 401(k)s, 403(b)s, pensions and IRAs, as the primary means of paying for care, while 25 percent are banking on their Social Security income, 7 percent would use health savings accounts (HSAs) and 6 percent would use emergency savings.

That last is particularly interesting, since so few people have successfully managed to set aside a sizeable emergency fund in the first place.

6. Despite their potential, HSAs just aren’t feasible for many because of their income.

HSAs do offer ways to set aside more money not just for medical bills in retirement but also to boost retirement savings overall, and come with fairly generous contribution limits. But people with lower incomes often can’t even hit the maximum for retirement accounts—so relying on an HSA might not be realistic for all but those with the highest incomes.

Yet people with lower incomes were more likely than those who made more to say HSAs would be the main way they’d pay for medical expenses. Among those who said they’d be relying on HSAs to pay for care in retirement, 5 percent of those with incomes less than $35,000 and 14 percent of those with incomes between $35,000–$50,000 said that would be the way they’d go.

Just 9 percent of those with incomes between $50,000–$75,000, 7 percent of those with incomes between $75,000–$100,000 and 9 percent of those with incomes above $100,000 chose them.

5. A few are planning on using an inheritance to pay for medical bills in retirement.

It’s probably not realistic, and there aren’t all that many, but some respondents are actually planning on an inheritance being the chief way they’ll pay for their medical expenses during retirement.

Millennials and GenXers were the most likely to say that, at 2 percent each—but they may not have considered that the money originally intended for an inheritance might end up going to pay for other things, such as caregiving or child care, and indeed much of their own retirement money could end up paying for care for elderly parents. A lot more people end up acting as caregivers—especially among the sandwich generation—and may find that relying on inheriting money from the people they’re caring for was not a realistic expectation.

4. Women don’t know, guess low.

Just 13 percent of women have gone to the trouble of estimating how much health care will cost them during retirement, but that didn’t stop 32 percent from putting that figure at $25,000 or less.

And that’s really bad news. It’s particularly important for women to be aware of the cost of health care, since not only do they not save enough for retirement to begin with—42 percent only contribute between 1–5 percent, the lowest level, compared with 34 percent of men, often thanks to lower salaries and absences from the workplace to raise children or act as caregivers—but their longer lifespans mean they’ll have more years in which to need health care and fewer options to obtain it other than by paying for it.

Men are frequently cared for by (predominantly female) caregivers at home, while women tend to outlive any family members who might be willing or able to do the same for them.

3. Men don’t know, but guess higher.

While the same percentage of women and men have not estimated their retirement health care expenses (81 percent), men were more likely than women (24 percent, compared with 15 percent) to come up with an estimate higher than $100,000.

2. The highest-income households are most likely to have tried to estimate medical cost needs during retirement.

Probably not surprisingly, households with an income of $100,000 or more were the most likely to have tried to pin a dollar figure to health care needs, with 21 percent saying they’d done so.

Households with incomes between $50,000–$75,000 were least likely to have done so, with just 11 percent of them trying to anticipate how much they’ll need.

And just because they have more money doesn’t mean their estimates were a whole lot more accurate—only 38 percent of those $100,000+ households thought they’d need more than $100,000 to see them through any needed medical care during retirement, while 59 percent—the great majority—figured they could get by on $100,000 or even less.

1. Where they live doesn’t seriously affect their estimates, although it will seriously affect their cost of care.

Among those who have tried to anticipate how much they’ll need in retirement for medical care, there’s not a huge difference among how many guessed too low—even though where they live can have a huge effect on how much they’ll end up paying, particularly for long-term care.

While the most expensive regions for LTC tend to be the northeast and the west coast, and the cheapest are the south and midwest, there’s not a great deal of variance among those who estimate they can get by on care for $100,000 or less—even if people live in one of the most expensive regions. Sixty-seven percent of those in the northeast said care wouldn’t cost more than that, while 63 percent of those in the midwest, 71 percent of those in the south and 61 percent of those in the west said the same thing.

When it came to those who said they’d need more than $100,000, 24 percent of those in the west thought they’d need that much; so did 20 percent of those in the midwest, just 18 percent of those in the northeast and 17 percent of those in the south.