Most retirement plans leave room for housing, food, travel, and a few surprise expenses. But there's one cost that doesn't get the same attention, and failing to plan for it is a huge trap for retirees: health care. That's the one expense that may hit hardest over time, even if you're healthy, while you're making your retirement plan.
HealthView Services projects lifetime health care costs of $955,411 under traditional Medicare options for a healthy 65-year-old couple retiring in 2026. This estimate includes premiums, deductibles, co-pays, co-insurance, and uncovered costs such as hearing, vision, and dental care.
That figure is easy to dismiss as an extreme case, but it is based on a couple entering retirement in good health. In other words, health care needs its own line in the retirement budget, even before serious illness, long-term care, or major medical problems enter the picture.
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Failing to plan for health care is the trap
Many people fall into the trap of assuming that Medicare removes the need to budget for medical costs. Medicare does help with many major expenses, but it doesn't make health care free.
You still have to account for premiums, deductibles, coinsurance, prescriptions, dental work, glasses, hearing aids, and any other uncovered services, which will need to come out of your savings. If you don't build these costs into your retirement plan, your income may be stretched much sooner than expected, or you may struggle to access the care that you need.
How much health care may really cost
HealthView Services estimates that $688,996 of the projected $955,411 comes from premiums alone. In that scenario, total annual health care costs, including premiums and out-of-pocket expenses, are projected to start at $17,003 in the first year of retirement and rise to $55,513 by age 85. The rest of the projected figure is made up of deductibles, co-pays, and miscellaneous uncovered expenses.
Why Medicare may not be enough
Original Medicare doesn't cover everything. Routine eye exams for prescription glasses, hearing aids and related fitting exams, most dental care, and long-term care are among the services generally not covered.
Part B also usually leaves beneficiaries paying 20% of the Medicare-approved amount after the deductible. Without Medigap, Medicaid, employer coverage, or another supplement, Original Medicare has no yearly out-of-pocket limit.
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Why the costs keep growing
The pressure on your budget gets worse because health care costs tend to rise faster than Social Security benefits. HealthView Services projects long-term retirement healthcare inflation of 5.8% per year, with a projected 2.4% average Social Security cost-of-living adjustment (COLA).
In 2026, for example, Medicare Part B premiums rose 9.7% while the Social Security COLA was just 2.8%. The longer your retirement, the more those differences compound into a serious shortfall.
Use an HSA while you are still eligible
If you're still working and covered by a high-deductible health plan, a Health Savings Account (HSA) is one of the better tools you have available.
You put money in pre-tax. It grows tax-free and comes out tax-free for qualifying medical expenses, including Medicare premiums and out-of-pocket costs in retirement.
The 2026 limit is $4,400 for individuals and $8,750 for families. There's also an extra $1,000 for those over 55. When you enroll in Medicare, contributions stop. A health savings account may help workers build a dedicated medical reserve before retirement.
Compare Medigap and Medicare Advantage early
There are two options to help reduce what you pay out of pocket for your health care needs. Medigap, also called Medicare Supplement Insurance, helps pay some out-of-pocket costs under Original Medicare, such as copayments, coinsurance, and deductibles, depending on the plan. Medicare Advantage replaces basic Medicare with a bundled plan that typically includes health, vision, and hearing benefits.
Costs vary by plan and location, but most people entering retirement without supplemental coverage end up paying significantly more than those who have it. Shopping around is important as networks, premiums, drug coverage, prior authorization, travel needs, and out-of-pocket limits all matter and everybody's needs differ.
Medigap often means paying higher premiums but reduces surprise bills. Medicare Advantage may come with lower premiums, but plan rules, provider networks, and annual changes can result in higher out-of-pocket costs.
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Build a dedicated health care reserve
Treat health care as its own item in your budget rather than something to be absorbed into general or miscellaneous spending. That might mean directing a set amount from Social Security income into a separate account each month, earmarking a portion of retirement distributions, or carrying an HSA balance into retirement specifically for medical costs.
The $955,411 projection includes both premiums and out-of-pocket costs. Having money already earmarked for both is how you avoid being caught short when those bills arrive.
Bottom line
Nearly $1 million in retirement health care costs sounds pretty extreme. However, for a healthy couple retiring at 65, this is a realistic projection, according to HealthView Services. One of the biggest financial mistakes retirees can make is not treating medical costs as a major retirement expense until the bills start rolling in and blowing the rest of the budget out of the water.
Where you live also has an impact on how much you are likely to spend on health care in retirement. HealthView Services found that a couple would spend around $878,565 in Washington State but over $1,000,000 in Missouri. Additionally, this projection does not include long-term care. That's something that you will need to provide for in your retirement plan separately.
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