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Shingles, a painful condition, is on the rise among older Canadians. The good news is there’s a vaccine — but it’ll cost you. Prepare your clients to manage out-of-pocket health-care costs in retirement.

With increasing life expectancies, it’s wise to help clients plan to live well into their 90s. And an important consideration is the inevitable increase in spending on health care in retirement.

Canada’s public health care system is considered one of the best in the world. But it doesn’t cover everything, and many clients are surprised at the size of the price tag. Between 1997 and 2009, average out-of-pocket health care spending in Canada increased by 2.9% annually. Households spending more than 10% of their total after-tax income on health care rose by 56%.1

Vaccines and preventative medicine are important considerations to help manage costs and alleviate the burden of treatment and recovery time. Help your clients understand what’s covered by the government, and what they have to pay for themselves. Education is the first step, and from there, you can help set your clients on a path to protect their health and financial well-being well into their retirement years.

SHINGLES: A CONCERN FOR CANADA’S AGING POPULATION

Shingles is a disease that causes a painful rash, and the risk of developing it increases significantly with age. Over 130,000 new cases are reported in Canada each year.2 The condition varies in duration and intensity among individuals, but the discomfort can be extreme — some sufferers describe it as an electric shock traveling along their body. Anyone who’s had chickenpox or the chickenpox vaccine can develop shingles later in life.

Canada’s National Advisory Committee on Immunization (NACI) recommends the shingles vaccine for adults at age 60.3 The recommended age is a trade-off; while the risk of developing shingles increases with age, the effectiveness of the vaccine decreases with each passing decade. After age 60, the vaccine’s effectiveness is cut in half. At age 70 it’s only about 40% effective, and by age 80 it declines to 20%.4 Canadians pay out-of-pocket for the vaccine — a one-time cost of about $200.

OUT-OF-POCKET VACCINE COSTS ARE ON THE RISE

While controversy has been stirring in recent years, health care professionals consider vaccines one of the most cost-effective health interventions available, saving the public millions of dollars in medical costs from vaccine-preventable diseases. Infectious diseases were the leading cause of death in the last century, but in Canada today, they account for less than 5% of deaths.5

In 2012, about 70% of the $500 million spent on vaccines was covered by provincial governments, with a focus on childhood and adolescent programs. The remaining $150 million was paid out-of-pocket or through benefit plans. At the time, 57% of Canadians had drug benefit insurance, but only 47% had drug benefit plans that covered preventative vaccines. That leaves 73% paying out of pocket.6

Public coverage for preventative vaccines varies across the country, with some Canadians paying up to $300 depending on their province.5 A growing number of vaccines aren’t covered by public programs, and for seniors, the risk of complications generally increases if they contract a disease.

Travel vaccinations are another consideration. Globe-trotting retirees need to protect themselves from a variety of viruses and diseases, and depending where they travel, the costs can add up.

Clients can ask their doctor or pharmacist about the recommended immunization schedule for their province, and a list of the recommended travel vaccines for their particular destination. You can also share ‘Travel vaccines: What to know before you go’ from Brighterlife.ca with clients.

THE MAJORITY OF CANADIANS AREN’T PLANNING FOR HEALTH-CARE COSTS

The 2014 Sun Life Canadian Health Index survey confirmed that the average annual personal health care cost for people 18 to 80 years of age was $1,511. If your client retires at age 65 and lives to be 95, that’s a $45,330 price tag. And with most provinces moving toward increasing out-of-pocket costs, a flat retirement income, and increased expenses with age, it’s critical that clients consider the implications and plan for them accordingly.

Educate your clients about their province’s public health care plans, including those that only apply to seniors. For example, the Ontario Drug Benefit Program for residents age 65 and older covers a portion of prescription drug costs. But it doesn’t cover everything, like preventative vaccines, so it’s still important for clients to set money aside to pay out-of-pocket expenses.

WHO PAYS FOR HEALTH CARE?

While the principles of the Canada Health Act (1984) remain sound, in the last 30 years there has been a six-fold increase in health costs.7

Sun Life developed a comprehensive guide outlining some of the coverage options, personal costs and other key considerations for each province.

FINANCIAL STRATEGIES FOR PREVENTATIVE CARE

Not having enough money to pay for health care is a stressful situation and can have serious consequences. Recent evidence suggests that almost 10% of Canadians who received a prescription in the previous year made compromises related to cost — they did something to make the prescription last longer, didn’t fill a new prescription, or didn’t renew a prescription. Canadians with lower incomes who didn’t have insurance were at greatest risk.8 Savings tools that provide short-term access to money and some growth — like Tax-Free Savings Accounts — can help clients save efficiently while providing the access they need for emergency care.

Vaccines are an important piece of the puzzle when talking to clients about their health in retirement, and it opens the door to a wider conversation about preventative care and managing increased health-care costs into their retirement years. Preparing for the possibility of physical and mental illness, and doing everything possible to reduce their risk, are critical to personal and financial well-being. Clients may be reluctant to think about the issue, but the earlier you help them start preparing, the better off they’ll be in retirement.


1 Law MR, Daw JR, Cheng L, et al. Growth in private payments for health care by Canadian households. Health Policy 2013; 110(2-3): 141-6.

2 Public Health Agency of Canada, 2014.

3 Public Health Agency of Canada, 2010.

4 CBC News, 2013.

5 Introduction to Vaccines: The Canadian Perspective. BIOTECanada. VIC. 2010.

6 2012 Estimates Insights Volume 8 Issue 3, 2013.

7 Canadian Institute for Health Information, 2013. National Health Expenditure Trends 1975 to 2013

8 Law MR, Cheng L, Dhalla IA, et al. The effect of cost on adherence to prescription medications in Canada. Canadian Medical Association Journal 2012; 184: 297-302.

Originally published on Advisor.ca