Medicare insurance coverage kicks in at 65 years of age, but recipients should start looking at the impact it will have on their retirement several years before that landmark date, according to Robert Klein, president of Retirement Income Center.

Many financial advisors, who have been concentrating on their clients’ accumulation of assets, are not familiar with the costs of Medicare––and they can be substantial, Klein says.

“Before 65 you have health insurance and you know the cost with an inflation factor,” Klein says. “When you hit 65 it’s different. It is absolutely something you should talk to you financial advisor about ahead of time and include in your retirement planning well before your retirement.”

Retirement Income Center is a registered investment advisor based in Newport Beach, Calif. Klein specializes in retirement income planning.

There are several choices under Medicare and each affects the costs of health care in retirement. Klein advises learning about the different parts of

Medicare (the A, B, C, D’s of Medicare), what each costs and what they cover so that the costs can be included in a person’s retirement plan.

Medicare is split into two different kinds of insurance. Original Medicare consists of Parts A and B and is taken by most people who turn 65. Part A pays for approximately 80 percent of hospital costs and deductibles apply, so if an extended hospital stay is required the costs still could add up.

Part B is medical insurance and pays for about 80 percent of medically necessary services from doctors and some other health care providers. There is a monthly premium that is means tested based on the person’s income for the prior two years. The premium this year ranges from $104.90 to $335.70, depending on an individual’s income.

Medigap policies sold by private insurance companies are available to cover the costs not covered by Medicare. That is another expense that needs to be considered when drawing up a retirement plan, Klein says.

Part D was added in 2003 and represents the largest overhaul of Medicare to date, says Klein. It helps cover the cost of prescription drugs, but there are co-payments and co-insurance and there is a coverage gap once the recipient reaches a certain level of expenses where he has to pay the cost of drugs until coverage kicks in again.

The cost for Part D is means tested and some people do not take it, which potentially makes the cost of drugs a large expense in retirement for some individuals if they are on a lot of prescriptions, Klein says. Private insurance companies sell the insurance.

Part C of Medicare insurance is a Medicare Advantage plan that combines Parts A, B and sometimes D under one policy.

In addition to the four parts of Medicare, there is still more to be considered when planning for health care costs in retirement, Klein warns. Medicare, for the most part, does not cover home health care or long-term care in a nursing home unless it is medically necessary.

For most nursing home care, a long-term care insurance policy is necessary. Nursing home care averages $50,000 a year and up and the costs keep rising, according to AARP.

Although long-term care insurance is expensive, it is less expensive than nursing home care. A long-term care policy can run $6,000 or more a year for a single person.

“Are you thinking of Medicare to be your long-term care plan?” Klein asks. “If so, you may want to rethink your plans.”

Klein wrote a blog entry on the subject that can be found on his Retirement Income Visions blog http://www.retirementincomevisions.com/retirement-income-visions/2013/05/are-you-depending-on-medicare-for-long-term-care-coverage.html.

For a useful Medicare primer, Klein recommends the official U.S. government publication that is updated yearly called “Medicare and You.”