A 65-year-old retiring in 2026 can expect to spend an average of $185,500 on healthcare and medical expenses over the course of retirement—not counting long-term care, most dental services, or many other health-related expenses. That figure, released by Fidelity Investments in July, is a useful one, but it doesn't shed much light on what today's wellness- and longevity-focused adults will actually spend throughout their lives to maintain, monitor, and improve their health before illness appears.
For younger adults, health spending is no longer a cost that crops up later in life. Many young adults are already using services, technologies, and protections offered by companies that sit somewhere between traditional healthcare, personal technology, and consumer wellness. They monitor exercise, sleep, heart rate, glucose, body composition, and VO2 max using wearable technology. They purchase genetic testing, advanced biomarker panels, continuous glucose monitors, GLP-1 medications, full-body scans, and increasingly sophisticated longevity programs.
Much of this spending is discretionary. Most of the products and services are expensive and the clinical evidence behind them is still developing. More measurement doesn't always produce better health, and it isn't always easy to separate a genuine advance from a well-marketed one. But the direction is clear: Health is becoming something people continuously invest in and manage.
Financial planning hasn't caught up with this trend. Instead of judging the clinical merits of longevity and wellness advances, advisors should recognize that clients are creating a new and potentially significant category of spendingthat may grow rapidly as technologies improve and new ones emerge.
3 health portfolios. If health is a durable form of capital that can be maintained or increased through investment, as economist Michael Grossman posited 50 years ago, why do we begin planning for it primarily when clients approach Medicare eligibility?
I propose organizing health-related spending into three portfolios.
The three portfolios overlap. A wearable might support prevention, performance, or condition management. The relevant question isn't what the product is. It is what job the client expects it to perform.
A new advisor-client discussion about longevity. Health often enters an advisor-client conversation in one of two ways: in an average retirement-cost estimate or with the question, "How is your health?" One is generic; the other often produces a one-word answer. Neither reveals the capabilities clients hope to preserve as they age and the funds they are willing to spend to achieve that goal.
The three portfolios provide a structure for a deeper conversation about health behaviors, aspirations, spending priorities, and risks, without requiring the advisor to become a physician, evaluate medical claims, or recommend treatments. That conversation might begin with the following questions:
The answers may reveal expenses that don't appear in conventional retirement models: a personal trainer, specialized nutrition, advanced diagnostics, home modifications, concierge medicine, new therapies, or periodic help from a care manager.
Advisors can then help clients decide how much to allocate, when to spend it, and what trade-offs it creates without judging the clinical merits of a particular service or intervention. They can build liquidity for technologies and treatments that don't yet exist. They can consider whether preventive and performance spending should be funded throughout adulthood rather than treated as a luxury competing with retirement saving. And they can connect those choices to insurance, housing, caregiving, and retirement-income decisions.
Advisors have spent decades helping clients accumulate and manage financial capital because it compounds and because its future value matters. Health capital has its own long horizon. Longevity planning cannot be reduced to financing more years. It must also consider how clients will fund the health and capabilities that make those additional years good ones.
Joseph F. Coughlin, Ph.D., is the founder of the Massachusetts Institute of Technology AgeLab and a researcher, speaker, and advisor exploring how demographic change and technology are reshaping business and society. He is the author of "The Longevity Economy" (Public Affairs) and co-editor of Longevity Hubs (MIT Press). In his website The Demographic Edge, he connects emerging signals in demographics, technology, markets, and changing lives to examine what comes next. His peer-reviewed paper, "From Health Costs to Health Portfolios: A Longevity Planning Framework," appears in the October issue of the Retirement Management Journal.
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