Medicare covers only 59% of the cost of health care for seniors–and retirees can expect to pay an even larger share in the future. In fact, a couple age 65 might need $387,000 saved in order to be confident of covering their health care costs in retirement, not including outlays for long-term care.

Those are findings from a new report from the Employee Benefit Research Institute (EBRI). Based on the latest data available, from 2009, Medicare paid 59% of health care services for beneficiaries 65 and older. Individuals enrolled in Medicare paid 13% out-of-pocket, private insurance covered 14%, and the balance came from other sources such as Medicaid and VA benefits.

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