Fidelity laid out five risks in a retirement planning guide published on October 12, each capable of draining a portfolio faster than most Americans expect. The five risks: healthcare costs outpacing Medicare, declining confidence in Social Security and Medicare, inflation quietly doubling expenses, portfolios too conservative to keep pace, and early withdrawals that accelerate every other shortfall. Employee Benefit Research Institute (EBRI) data confirms pressure from these risks is already visible in public sentiment. Fidelity urged retirees and near-retirees to evaluate how exposed they are to each of the five. Also Read: Fidelity, AARP sound alarm on 401(k)s, IRAs Healthcare costs are consuming a bigger share of retirement income than most plans cover A 65-year-old retiring in 2026 will need approximately $185,500 in after-tax savings just for healthcare expenses throughout retirement, Fidelity’s 25th Annual Retiree Health Care Cost Estimate found. That total accounts for Medicare premiums, copayments, deductibles, and prescription drug costs, but it excludes long-term care. Nearly 70% of Americans aged 65 and older will need some form of long-term care, the U.S. Department of Health and Human Services reported. A private nursing home room now costs approximately $129,575 per year at the national median. Assisted living costs about $74,400 per year nationally, and non-medical home care averages $80,080 annually, based on a median rate of $35 per hour for 44 hours of care per week, according to the CareScout 2025 Cost of Care Survey. Craig Copeland, Director of Wealth Benefits Research at EBRI, explained the financial anxiety those costs are generating. Americans are contending with a mix of immediate financial pressures and long-term uncertainty…Together, those pressures are making it harder for people to feel secure about their retirement, Social Security provides an average retired-worker benefit of approximately $2,071 per month. Against six-figure healthcare obligations and potential long-term care needs, that monthly benefit covers only a fraction of the total exposure. EBRI data confirms retirement confidence at a near-decade low Workers’ confidence in having enough money for a comfortable retirement fell six percentage points from 2025 to 61%, the EBRI 2026 Retirement Confidence Survey found. Retirees’ confidence dropped five points to 73%, a near-decade low. Concern about changes to Social Security and Medicare is driving this decline. Seven in 10 retirees and four in five workers said they are worried the government will alter the U.S. retirement system. Only about half of workers expressed confidence that those programs will continue to deliver equal value. More Fidelity: Dave Ramsey raises a $185K risk Fidelity pegs for retirees Fidelity’s data makes Suze Orman’s 401(k) warning hard to ignore Fidelity puts a stark number on healthcare in retirement Nearly six in 10 workers said healthcare costs are hurting their ability to save for retirement. Two in five retirees reported that healthcare expenses have been higher than expected, the EBRI survey confirmed. Declining confidence is also affecting expectations about when workers will retire. A growing share said they do not plan to retire, and nearly one-quarter adjusted their target retirement age in 2025. Most pushed it later, while current retirees reported a median retirement age of 62. Retirement confidence has fallen to a near-decade low as rising healthcare costs and concerns over Social Security push workers to reconsider retirement plans. Korrawin / Getty Images Inflation, conservative portfolios, and heavy withdrawals compound the damage Fidelity’s remaining three risks amplify the pressure on healthcare and longevity. Inflation is the most persistent, reducing purchasing power in a retirement account steadily over time. Even a moderate 3% annual rate roughly doubles the cost of goods and services over 25 years, Fidelity illustrated. A retiree spending $50,000 a year on essentials at age 65 would need closer to $100,000 for the same standard of living by age 90. Compounding inflation makes overly conservative portfolios especially damaging over a retirement spanning three decades or more. Retirees who shift into bonds or cash may protect against short-term volatility but sacrifice the long-term growth stocks can deliver. Fidelity recommended a balanced asset mix reflecting both risk tolerance and a time horizon exceeding 30 years. Withdrawing too much, too early, accelerates the damage from other risks because it depletes a portfolio already straining to outpace rising costs. Fidelity recommended capping first-year withdrawals at 4% to 5% of total savings, then adjusting for inflation each year to sustain income over a 20- to 30-year retirement horizon. What retirees and near-retirees can prioritize before year-end Fidelity recommended starting with a healthcare cost projection for the full length of your expected retirement, an exercise fewer than half of Americans have completed, according to EBRI. The firm described a health savings account (HSA) as offering a “triple-tax advantage” for closing that gap: pretax contributions, tax-free growth, and tax-free withdrawals for qualified medical expenses that carry into retirement. Fidelity also recommended researching long-term care insurance early, because premiums rise with age and the same amount of coverage becomes more expensive to purchase each year the buyer waits. Income annuities offer guaranteed payments for life that cover essential expenses beyond Social Security, Fidelity noted. More than four in five workers have expressed interest in purchasing a guaranteed monthly income product with their retirement savings, according to the EBRI survey. Fidelity framed a year-end portfolio review measuring allocation, income sources, and spending rate against its five-risk framework as a core planning step heading into 2027. Related: Fidelity maps out a retirement paycheck step for steady income
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