Americans are certainly known for having their excesses. Unfortunately, saving for retirement doesn't usually happen to be one of them.

The average citizen is woefully underprepared for his or her golden years. And while some folks may pride themselves on being ahead of the curve and having a fatter 401(k), a new study has come out with some alarming numbers that show why a comfortable retirement may be even more out of reach than previously expected.

Dangerous diagnosis
Recent data from the Center for Retirement Research (CRR) at Boston College estimate that a relatively healthy 65-year-old couple can expect to spend $197,000 on health-care costs over the course of their remaining lives. Ouch! And that amount doesn't even include nursing-home costs, which would further inflate that total. According to the study, when the costs of nursing-home care are included, there is actually a 5% chance that total health-care expenses could exceed $570,000. That's quite a shocker, given that few retirees have surpassed the half-million-dollar mark in assets.

But won't Medicare help defray health-care costs? Well, it will certainly cover a fairly wide range of expenses, but as anyone who has dealt with Medicare can tell you, it won't cover all services that you may need. Additionally, Medicare coverage is subject to (sometimes hefty) co-payments and/or monthly premiums. The CRR's study fully takes Medicare coverage into account, meaning that you'll need at least $200,000 more over your lifetime beyond what coverage you can expect from the government. That means we've all got some work to do to meet these demands.

Planning ahead
If you can afford the premiums, you might want to consider purchasing long-term care insurance to fill some of the gaps left by Medicare. According to the U.S. Department of Health and Human Services, roughly 70% of adults over age 65 will need some type of long-term care during their lifetimes. Long-term care is generally not provided by Medicare, so these costs can quickly add up. To learn more about long-term care insurance, take a look at the Health and Human Services National Clearinghouse for Long-Term Care website as a good starting point.

The staggering costs of health insurance late in life certainly aren't reassuring for millions of Americans struggling to save anything at all for retirement. But the fact remains that we've all got to do a better job of saving if we want to be able to pay for health care in our old age. That means taking control of spending and cutting down on some unnecessary items. To get a better grip on where your money goes every month, think about getting familiar with a personal-finance program like Quicken (on your desktop) or (online). Once you've analyzed your spending patterns, you have a better chance of seeing where you can cut and boosing your retirement savings instead.

Goosing your nest egg
Of course, even if you've managed to amass a meaningful nest egg, you've still got to invest those dollars for the long haul. Unfortunately, like too many workers, you may be stuck inside a high-cost 401(k) or other retirement plan with few good investment options. If that is the case, make sure that you're at least maximizing any matching dollars that the company may offer you. Even if this money in invested in less-than-optimal funds, you'd be crazy to pass up any free money.

Once you've maxed out any matching contributions, think about opening up an IRA, where you have more freedom in picking investment options if your regular retirement plan leaves a lot to be desired. In this case, going with some broad-based, inexpensive exchange-traded funds might not be a bad idea, once you've got your asset-allocation plan down pat. Some of the better options include:

Exchange-Traded Fund

Types of Companies Invested in

Vanguard Total Market Stock ETF (NYSE: VTI)

Apple, Procter & Gamble (NYSE: PG)

iShares Russell 2000 ETF (NYSE: IWM)

Palm (Nasdaq: PALM), RF Micro Devices

Vanguard FTSE All-World Ex-US ETF (NYSE: VEU)

Total SA, Petroleo Brasileiro (NYSE: PBR)

iShares Barclays Aggregate Bond (NYSE: AGG)

U.S. Government & Agency Bonds; Investment-Grade Corporate Bonds

Likewise, when it comes to long-term investing for retirement, remember to keep it simple. Stick to inexpensive ETFs and actively managed funds that invest in broad swaths of the market. Leave the single-country funds and triple-leveraged inverse ETFs to someone else. Although it may be difficult to ignore the hot trends of the minute, just remember that today's superstar winners (gold, anyone?) could very likely end up being tomorrow's underperformers. Keep your focus on your long-run goals and try to tune out the day-to-day noise in the market. It isn't easy, but ignoring short-term trends is vital to your success.

Health-care costs may seem like a huge dark cloud looming over our golden years, but with a little bit of planning, and a lot of saving, we can ease into retirement with a hefty cash cushion. Still, it won't get any easier by waiting for tomorrow, next week, or next year. Take steps to meet these demands now -- down the road, you'll be glad you did.

For more insider investing and personal financial planning tips, check out the Fool's Rule Your Retirement service, which provides top-notch retirement and mutual fund advice. You can start your free 30-day trial today.

Amanda Kish is the Fool's resident fund advisor for the Rule Your Retirement investment newsletter. At the time of publication, she did not own any of the funds or companies mentioned herein. Apple is a Motley Fool Stock Advisor selection. Petroleo Brasileiro, Procter & Gamble, and Total SA are Motley Fool Income Investor picks. The Fool owns shares of Procter & Gamble. The Fool has a disclosure policy.