Key Takeaways:
Worries about market swings, outliving savings, housing and cognitive decline pushed a monthly gauge of retiree concerns higher in September, reversing part of an August reprieve and leaving the measure almost 22 percentage points above where it started the year.
"Even if you have $10 million, you still have fears about retirement," said David Conti, the retirement coach who publishes the Retirement Fear Index and spent 18 years in Fidelity's wealth-management department. "The good news is that about two-thirds of the index's big 10 fears are actionable. So, with good financial planning and retirement coaching for the nonfinancial side, people can do something about them."
The index weights 10 fears by how much national attention each commands, drawing on a meta-analysis of 28 sources that include research from the Center for Retirement Research at Boston College and the Employee Benefit Research Institute, plus Social Security Administration trustees' solvency estimates. Healthcare and long-term-care costs carry the heaviest weighting, followed by outliving savings, Social Security and pension insolvency, inflation and rising everyday costs, and cognitive decline. Market volatility and sequence-of-returns risk, loss of purpose, housing affordability, family caregiving burdens and taxes round out the list. Conti distinguishes fear from anxiety: "Anxiety is something that might happen in the future and fear is more of a present threat," he said on the "Friends Talk Money" podcast.
The stakes are concentrated in long-term care, where only about 10% of Americans hold insurance, according to Conti. Retirees routinely overestimate what Medicare covers for nursing-home stays and custodial care, leaving the gap to be funded from savings. The index's earlier 2026 climb reflected tariff-driven inflation, higher gasoline prices tied to the Iran conflict and wider market swings; August's dip followed cooling inflation and a stronger University of Michigan Consumer Sentiment Index reading before September reversed part of that decline.
Conti's split between actionable and nonactionable fears is the index's practical core. Risk management, investment allocation and insurance protection address most of the top 10, while a smaller group he calls "psycho-spiritual" — family conflict and identity loss among them — resists a spreadsheet fix. For Social Security solvency concerns, the response he recommends is reducing dependence on government income rather than forecasting the program's fate. "You can reduce your debt," he said.
Healthcare fears have a nearer deadline. Medicare open enrollment opens in October, giving current and future participants a window to compare plan types available in their areas, review current medications and doctor visits, and estimate whether a procedure or new prescription is likely in the coming year. Conti's advice is to start learning the program's structure before that window closes rather than after a health event forces the decision.
Taxes sit at the bottom of the index's weighting but represent what Conti calls one of the top categories retirees fail to budget for. "In terms of retirement budgeting, it's one of the top categories retirees do not budget for because people don't think much about it," he said. That omission compounds over a multi-decade retirement, since withdrawals from tax-deferred accounts, Social Security benefit taxation and required minimum distributions all create liabilities that a pre-retiree's working-year budget never captured.
David Luff, a digital health executive in Portsmouth, N.H., retired last October at 67 with the same three concerns at the top of his list: whether he and his wife would have enough money, what healthcare would cost, and how they would handle long-term care. "My fears were about things I can control, not things I can't — like the economy and inflation," Luff said. He now spends two to three hours a day working out, up sharply from his working years, and has begun evaluating continuing care retirement communities, where residents enter independent living units and can transfer to assisted living if needed. "If we could get into a place like that, it will be there to take care of us," he said.
Three scheduled events could move the index next. The fall announcement of 2027 Medicare Part B premiums sets a direct cost for every enrollee, the Social Security trustees' 2027 report will refresh solvency projections that feed the insolvency fear, and the 2028 presidential election introduces the prospect of tax and regulatory changes. Each can raise retirement costs or shift confidence in retirement security, which is why the index treats them as forward inputs rather than background noise.
For pre-retirees, the index's practical read is that most of what they fear has a corresponding action with a date attached — a debt balance to pay down, a Medicare plan comparison to complete before open enrollment closes, a tax line to add to the retirement budget. The nonfinancial fears are harder to price, but Conti's framing puts them in the same planning conversation rather than outside it.
This article is for informational purposes only and does not constitute investment advice. Figures and program rules cited here reflect the source material and reporting available at the time of writing; readers should verify current Medicare, Social Security and tax provisions against the latest official announcements.
