(Bloomberg News) Retirees may pay about $20,000 more for medical care if the U.S. Supreme Court overturns the 2010 health care overhaul, Fidelity Investments said.

A 65-year-old couple retiring this year will spend $240,000 out-of-pocket for care before their deaths, after accounting for Medicare coverage, Fidelity said in an annual estimate released today. That's an increase of $10,000 from last year and includes premiums and co-payments under Medicare and supplementary coverage called Medigap, the Boston-based mutual-fund manager said.

Passage of the health law saved money for seniors who among other benefits gained additional coverage for prescription drugs, said Sunit Patel, senior vice president for Fidelity Benefits Consulting, who led the project. The cost of losing those benefits, should the court overturn the law, would be about $20,000, Patel said in an interview.

"Seniors would have a much greater financial burden," said Ron Pollack, executive director of Families USA, a health advocacy group in Washington that supports the law. "They would not receive preventive care services for free, and seniors with chronic health conditions would have a much larger cost for purchasing prescription drugs."

The Supreme Court is weighing whether the law's requirement that most Americans have health insurance is constitutional, and if not, how much of the law to overturn. Former Massachusetts Governor Mitt Romney, who is poised to be the Republican nominee for president in November's election, has said he would repeal the entire law "as quickly as possible" should he take office.

The court may preserve the drug benefit for seniors, which closes a gap in Medicare's coverage for prescription medicines known as the "doughnut hole." About 78 percent of people polled by the Kaiser Family Foundation in April said they held a favorable view of that provision. Medicare is the U.S. health program for the elderly and disabled.

"There could be a scenario where that's one of the few pieces of reform that stick," Patel said.

A spokeswoman for Romney, Gail Gitcho, didn't respond to an e-mail seeking comment on the report.

Fidelity estimated that people retiring at age 65 in 2011 faced $230,000 in out-of-pocket health costs. The amount went up about 4.3 percent this year because of rising health care costs, according to the report. The rate of growth is lower than the historical average of 6 percent, prior to passage of the health law.