Each year, Fidelity Investments estimates the health care costs for a couple in retirement until death. The number is both terrifying and laughable, routinely in quarter-million-dollar territory.

Yes, $250,000 on top of the millions needed to fund retirement. Oh, and it doesn't include the cost of nursing home care.

No wonder 68 percent of the pre-retirees surveyed placed the cost of medical care in retirement in their trifecta of top financial concerns (outliving money and inflation were the other two).

The Boston-based financial company released its estimate for a 65-year-old couple retiring in 2011 on Thursday. Surprisingly, the estimate dropped 8 percent to $230,000 thanks to recent changes to Medicare.

Unfortunately, the drop is expected to be a one-time only "break." Expenses should continue rising steadily in the future.

Since the company started calculating the number in 2002, the annual health care costs estimate has increased an average of 6 percent annually.

Curious about what goes into this number? Here is the methodology:

Fidelity recently created the Guide to Retirement Income Investing , which includes a section on planning for health care costs.