Fidelity's 2025 Retiree Health Care Cost Estimate says a 65-year-old couple retiring today will need approximately $315,000 to cover healthcare costs in retirement. That number doesn't include long-term care. Read that again: $315,000 AFTER Medicare, AFTER premiums, just for the healthcare costs that remain. This is the expense that derails more retirement plans than any other, and the one most retirees plan for least.

$315,000
estimated healthcare costs for a 65-year-old couple through retirement
$185/mo
2026 Medicare Part B premium per person
$6,600/yr
average out-of-pocket healthcare costs per Medicare beneficiary

Where the Money Actually Goes

Retirement Healthcare Cost Breakdown (Per Couple, Over 20 Years)

Medicare premiums (B & D)
120000
Medigap or Advantage copays
55000
Dental care
35000
Vision & hearing
20000
Prescription drug costs
50000
Out-of-pocket medical
35000
Source: Fidelity Retiree Healthcare Cost Estimate, 2025; HealthView Services

The Costs Medicare Doesn't Cover

Medicare is excellent insurance — but it's not comprehensive insurance. The gaps are significant and often surprising to new enrollees.

What Medicare Covers vs. What You Pay Out of Pocket

ServiceMedicare CoverageYour Estimated Annual Cost
Most doctor visits80% after deductible$500-$1,200 in copays/coinsurance
Hospital staysDays 1-60 after $1,676 deductible$1,676+ per hospitalization
Dental (cleanings, fillings, crowns)NOT covered$1,000-$3,000
Vision (exams, glasses, contacts)NOT covered (except medical eye conditions)$300-$800
Hearing aidsNOT covered under Original Medicare$1,500-$6,000 per pair
Long-term care (nursing home, home aides)Very limited (100 days max skilled nursing)$60,000-$120,000/year if needed
Dental implants, denturesNOT covered$3,000-$30,000+
Prescription drugsPart D with $2,000 annual cap in 2026$0-$2,000 depending on medications

Building Your Healthcare Budget

Annual Healthcare Budget Worksheet

1
Medicare Premiums
Part B: $185/month ($2,220/year) per person. Part D: $30-$80/month per person. Medigap Plan G: $150-$300/month per person. Total per couple: $8,000-$15,000/year in premiums alone.
2
Out-of-Pocket Medical
Budget $2,000-$4,000 per person per year for copays, coinsurance, deductibles, and services Medicare doesn't fully cover. Track actual spending your first year and adjust.
3
Dental
Budget $1,000-$2,500 per person per year if you need more than basic cleanings. Consider a dental discount plan ($100-$200/year) instead of dental insurance — for retirees, the math often favors discount plans.
4
Vision and Hearing
Budget $300-$500/person for annual eye exams and glasses. If hearing aids are needed, budget $2,000-$5,000 every 5 years. Over-the-counter hearing aids (FDA approved since 2022) cost $200-$800.
5
Emergency Fund
Keep $10,000-$20,000 earmarked specifically for healthcare surprises — unexpected surgery, a dental emergency, or a specialist not fully covered by your plan. This is separate from your general emergency fund.

Strategies to Reduce Healthcare Costs

  • Use an HSA (Health Savings Account) if you're still working with a high-deductible plan before Medicare — contributions are tax-deductible, growth is tax-free, and withdrawals for medical expenses are tax-free. Triple tax advantage.
  • Compare Medigap vs. Medicare Advantage annually during open enrollment — your optimal choice can change as your health needs change.
  • Use GoodRx or Cost Plus Drugs (Mark Cuban's pharmacy) for prescriptions — prices are often lower than your insurance copay.
  • Get dental work done at dental schools — supervised care at 50-70% of private practice costs. Quality is often excellent.
  • Maximize preventive care — every free Annual Wellness Visit, every covered screening, every immunization. Prevention is infinitely cheaper than treatment.
  • If you're low-income, apply for Medicare Savings Programs and Extra Help (Part D subsidy) — millions of eligible people don't apply because they don't know these programs exist.

The $315,000 number is sobering but manageable when you plan for it. Budget $12,000-$20,000 per year per couple for total healthcare costs, invest specifically for healthcare expenses, and use every cost-reduction strategy available. The retirees who struggle aren't the ones who face high costs — they're the ones who didn't plan for them.