Were you enjoying today, so far? Well, prepare for a shock, because Fidelity Investments has some bad news. As they do every year, they're updating us on how much we might expect to have to fork over during retirement for our health-care needs. It's not a piddly sum, and you'll likely have to pay it when you're living on a fixed income.

Without further ado, here's the sobering news: A couple that's 65 years old and retiring this year will need about $240,000 in retirement just for medical expenses. This number is up almost 7% from a year ago, and some 50% since 2002. While it assumes no health-care coverage from a previous employer, it does include Medicare, but excludes a bunch of additional health-related expenses, such as over-the-counter medications, most dental services, and long-term care.

Why the increase? Well, Fidelity points to higher costs for doctor visits and diagnostic tests, increased expenses for new technology, and general inflation.

That's the bad news. It's bad mainly because it may represent a huge chunk of your retirement nest egg. If you've saved diligently and have managed to accumulate a million dollars by retirement, health-care costs alone could eat up a quarter of that, leaving you with less than you expected to live off.

The good news
There is good news, though. For starters, the whole health-care landscape in the U.S. may be vastly different within a few years, as the Obama administration has made it a priority to reform our health-care system and establish some kind of coverage for everyone. That may well end up reducing the out-of-pocket expenses faced by retirees. But let's not count on anything yet, OK?

We can also start saving and investing now, in preparation. You might want to have a separate account where you save just for future medical expenses. Here's how you can reach $240,000:

If you sock away this much each year

And it grows at

Then it will become $240,000 in

$3,800

10%

20 years

$6,900

10%

15 years

$13,700

10%

10 years

$3,000

12%

20 years

$5,800

12%

15 years

$2,300

14%

20 years

$4,800

14%

15 years

Obviously, the higher your average annual return, the faster you'll reach your goal. That's easier said than done, though. Investing in a simple broad-market index fund will get you the market's average return, which has been roughly 10% over many decades, but could end up being 8% or 12% or something else over the few decades (or less) in which you invest.

You can aim higher by adding some carefully chosen stocks to your mix. Here are some contenders you could research further: I found them on Motley Fool CAPS by screening for large-cap stocks that earned five stars (out of five), that have returns on equity (ROE) of 15% or more, long-term debt-to-equity ratios of no more than 0.5, and dividend yields of 2.5% or more:

Company

ROE

Long-term Debt-to-Equity

Dividend Yield

BP (NYSE:BP)

23%

0.17

8.3%

CNOOC (NYSE:CEO)

27%

0.07

4.8%

Illinois Tool Works (NYSE:ITW)

20%

0.16

3.9%

Novartis (NYSE:NVS)

16%

0.04

4.6%

Arcelor Mittal (NYSE:MT)

17%

0.46

2.6%

Taiwan Semiconductor (NYSE:TSM)

22%

0.01

4.1%

Johnson & Johnson (NYSE:JNJ)

31%

0.19

3.5%

Data: Motley Fool CAPS.

The above companies might serve you well, but do your homework before investing in them. Or conduct your own screens, looking for companies that fit your most important criteria.

If you'd like to set yourself up for a mostly painless retirement, where you're not held hostage by health-care costs, it takes planning. But if you're smart and start early, you can save more than enough to cover all your retirement costs.

Meanwhile, learn more about other health-care possibilities and issues:

For more advice, try our Rule Your Retirement newsletter service for free, with full access to all past issues. It regularly offers recommendations of promising stocks and mutual funds.

Frustrated with your 401(k)? Even if your employer's plan isn't the greatest, you don't have to give up your dreams of a happy retirement. Get the tips you need to turn your retirement savings around in our special report, "How To Make The Most of Your 401(k)" -- just click here for instant free access.

Longtime Fool contributor Selena Maranjian owns shares of Novartis and Johnson & Johnson. CNOOC and Novartis are Motley Fool Global Gains selections. Johnson & Johnson is a Motley Fool Income Investor selection. Try our investing newsletters free for 30 days. The Motley Fool is Fools writing for Fools.