Q. Even though I'm retired and on Medicare, I still have a lot of out-of-pocket medical expenses. How can I lower my health care costs?

A. Medical expenses are likely to be one of your biggest expenses in retirement. Fidelity estimates that the average 65-year-old couple retiring in 2013 will need $220,000 to cover health care expenses throughout their lifetimes -- not counting potential long-term-care costs. But there are ways to prepare for and reduce health-care expenses.

-- Reduce your drug costs. About one-fourth of retiree health care expenses are for out-of-pocket prescription-drug costs, according to Fidelity. You can save a lot of money by switching from brand-name to generic drugs. That lowers your co-payments and minimizes the effect of the notorious doughnut hole -- the portion of prescription-drug costs Medicare Part D forces you to cover out of pocket. When your prescription-drug costs reach $2,970 in 2013 (including your share and the insurer's share), you have to pay for the prescriptions yourself until your total out-of-pocket cost reaches $4,750 for the year. (In 2013, you get a 52.5-percent discount on brand-name drugs and a 21-percent discount on generic drugs in the doughnut hole.)

Ask your doctor if your drugs have a generic alternative, and use the AARP Doughnut Hole Calculator (http://doughnuthole.aarp.org) to see if any other drugs are therapeutically similar but have lower costs or better coverage. "A lot of drugs have come off patent in the past few years, and 2013 and 2014 will still be big years for even more drugs coming off patent," says Sunit Patel, senior vice-president of Fidelity's benefits consulting group.

-- Find the best Medicare plan. Even if you've been happy with your coverage, check out your options every year. Many plans have been raising premiums, boosting out-of-pocket costs and restricting coverage networks, and the plan that cost the least in the past may no longer be your best deal. You generally can change plans only during open-enrollment season (from October 15 to December 7 for the next calendar year), but you can switch to a Medicare Advantage plan with a five-star rating anytime during the year, if you live in an area that has such a plan.

It can also help to review your options if you have a medigap policy. Some newer medigap plans have lower premiums in return for more cost sharing. Or you may want to consider switching to a Medicare Advantage plan, which provides both medical and prescription-drug coverage from a private insurer, and may also include some coverage for vision, dental and hearing.

(Kimberly Lankford is a contributing editor to Kiplinger's Personal Finance magazine and the author of Ask Kim for Money Smart Solutions (Kaplan, $18.95). Send your questions and comments to moneypower@kiplinger.com. And for more on this and similar money topics, visit http://www.Kiplinger.com.)