SAN FRANCISCO (MarketWatch) Retirement health-care costs are enough to cause a severe anxiety attack. Even with Medicare benefits, a 65-year-old couple retiring in 2012 will spend at least $240,000 in retirement, according to the latest estimate from Fidelity Investments.

That doesnt include long-term-care costs, over-the-counter medications and most dental costs.

Plus, that $240,000 estimate is based on average life expectancy for a 65-year-oldthe husband living until age 82 and the wife until 85but average means half of people live longer than that.

In other words, that 65-year-old couple may well need much more than $240,000.

No wonder almost half of wealthy Americans close to retirement said they are extremely worried about the effect health-care costs will have on their plans, according to a recent survey, by Harris Interactive for Nationwide Financial, of people with more than $250,000 in household assets.

When youre young, you cant envision what its actually going to cost you, said Henry Hebeler, a former Boeing executive who created AnalyzeNow.com, a retirement-planning website.

As you get older, thats when you start having the medical bills, said the 78-year-old Hebeler. I missed one day of work for sickness in 33 years at Boeing. And then I retired, he said.

Despite being relatively healthyhe and his wife still ski, for instancehes been in the hospital a number of times since retiring, he said, including for knee surgery. He details some of his experiences on his website.

Get your budget straight

If youre still in the retirement-planning stage, you might be envisioning lower living costsno more commuting, buying business attire, setting aside huge sums for retirement.

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Your retirement health-care tab will run $240,000