Though market conditions now appear to be stabilizing, many forty-somethings and younger find themselves questioning whether either program will exist when they retire and are planning for worst-case scenario. Financial advisers are trying to address the most immediate of these concerns, Medicare, by helping clients arrange ways to self-fund their healthcare after retirement. They are encouraging those under fifty to be more conservative in their spending during their remaining working years and to establish larger cash reserves to cover unanticipated healthcare costs in their elder years. Few think that Medicare will ever completely disappear, rather it will probably assume some other form as it would be political suicide for any elected official to allow the system to fail.

This kind of uncertainty has led many to prepare for health expenses during retirement differently. For a married couple retiring in 2009, the total medical costs during retirement (beyond Medicare) would average around $240,000 according to Fidelity Investments. Some people are saving for these kinds of expenses through health savings accounts, which function like a 401(k) for health care costs. It is tax-free to withdraw the money for medical costs, and if these costs end up being less than anticipated, the remainder acts like an ordinary retirement account.