Half of affluent pre-retirees say they are "terrified" of the effect health care costs will have on their retirement plans, according to a report released Monday by Nationwide Financial. Three-quarters of respondents said health care costs "going out of control" was their top retirement fear.

In spite of those fears, 38 percent of affluent pre-retirees still haven't spoken with a financial advisor about their retirement, and those who haven't aren't talking about health care costs. Just 20 percent have discussed health care costs that won't be covered by Medicare.

Part of the problem, according to the survey, is that pre-retirees don't think advisors are qualified to speak about health care costs. Almost 60 percent said they believe most advisors aren't able to speak about the cost of health care with their clients, even though two-thirds of clients who have spoken with their advisors say they've been very helpful.