A new study from Nationwide shows a clear majority of over-50 Americans are worried about health care costs, but only 43% have discussed the issue with their financial advisor.

John Carter, president and chief operating officer of Retirement Plans for Nationwide, says that seven out of ten "affluent pre-retirees" over the age of 50 "list soaring retirement health care costs as their number one fear."

Additionally, a separate study from Voya Financial shows 81% of U.S. adults "have not estimated the total amount health care will cost them in retirement."

Yet when asked by Voya to estimate their likely costs of health care in retirement, a majority of survey respondents underestimated the amount of money they'd need, based on health care industry calculations, the report states. Baby Boomers are the demographic most vulnerable to struggling with high health care costs in retirement. "Boomers were the most likely to say that they plan to use Social Security as their primary funding source for health care expenses in retirement, excluding Medicare," Voya reports.

Actual retirees say that anyone nearing retirement should have a good grip on health care costs once they're out of the workforce, with long term care an obvious point of concern.

"For retirees, the aging and health care issue boils down to two key points - death and long term care," states Ray Boyer, a 69-year-old retiree who resides in Evanston, Ill.

"Death is easy for figuring out health care financial costs," Boyer explains. "I can use actuarial tables and what my gut tells me to plan out how to have enough money to keep my household going. Thus, the question of running out of money, while important, is distinctly secondary to fear of the need for long term care."

Boyer says that if he or his wife need such care there is simply "no logical way" to pay for it. "If we need it - which is a very likely thing at some point - it will suck away our savings at lightning speed, and either leave us or the one who survives destitute and a burden on our kids," he says.

In one large sense, financial advisors wish all of their clients were like Boyer, who obviously acknowledges his concern of over future health care costs, and is willing to talk about it openly.

The fact is, as Nationwide points out, most don't. And that's a problem for financial professionals, who often need to get creative to "break through" to clients on health care finances.

"As financial advisors, it's our job to have the tough conversations with clients so they can be prepared for multiple scenarios," states Derek Mazzarella, a money manager with The Bulfinch Benefits Group, in Needham, Mass. "But in terms of health care costs in retirement, you have to relate to them. Unfortunately, most people know of a family member or a friend that has had to go through some extensiveness health problems later on in life. You have to ask them questions about that experience and find out what's important to them."

To break the issue down, Mazzarella advises retirees to realistically target three sources of personal health care assets - self-funding, Medicaid, and buying insurance.

"Self-funding is possible if there is enough money set aside, but medical care can cost a few thousand dollars a month for in-home care, or around $12,000 per month for a facility," he says.

Medicaid is an option if the consumer does the proper planning ahead of time or if he or she has minimal assets. "But Medicaid isn't always the most attractive option since the government will now be in control of your care which will limit the available facilities," Mazzarella says.

Your best bet may be to cover the risk with long term care insurance or with some hybrid life insurance policies that enable you to use a portion of a policy-based death benefit to pay for long term care costs. "Insurance can be costly and you may not qualify based on your health," he warns. "Yet insurance may be a good option if you'd like to have more control over your care and leverage the benefits from a policy."

Another tips for advisors working with clients on future health care costs - ask the right questions.

Ask your clients, "Are you concerned about affording medical care in your retirement?" or "What are your plans for care in your later retirement years?" says Jonathan J. Monjazi, founder of Monjazi Capital in San Diego.

In general, the most important thing advisors can do is bring up the subject, then ask the client if they have a plan for their health care costs, Monjazi adds. "If they do, great, they should evaluate the plan together. If not, then it's time to come up with a plan that alleviates concerns but also ensures the right steps are taken so those costs can be met," he says.

For financial advisors, the mission is to dig your heels in, get creative, and ask the right questions to get clients to open up about future health care costs in retirement. Failure is not an option - your clients future, both medically and financially may be depending on it.