Retirement healthcare cost calculator

Before 65 most early retirees buy an ACA marketplace plan. The sticker premium depends on your age, where you live, and the metal tier (bronze, silver, or gold), and it rises steeply with age — a 60-year-old's premium can be roughly three times a 21-year-old's. What you actually pay is that premium minus your ACA subsidy (premium tax credit), plus out-of-pocket costs up to the plan's maximum. This calculator estimates a typical premium from your age and area, or you can enter exact quotes from HealthCare.gov.

The ACA premium tax credit caps what you pay for the benchmark (second-lowest-cost silver) plan at a set percentage of your income. That percentage comes from the 2026 applicable-percentage table — about 2.10% of income under 150% of the Federal Poverty Level (FPL), rising to 9.96% at 300–400% FPL (Rev. Proc. 2025-25). The credit is the benchmark premium minus that required contribution, and it applies to whichever plan you pick. Because the credit is based on your retirement income (MAGI), managing income with Roth conversions and capital-gain timing directly changes your subsidy.

The enhanced ARPA/IRA subsidies expired December 31, 2025, so for 2026 the original ACA structure returns with the subsidy cliff reinstated: if your MAGI is at or above 400% of the Federal Poverty Level you get no premium tax credit at all and pay the full unsubsidized premium. A single dollar over the line can cost thousands, so keeping MAGI just under 400% FPL is one of the highest-value moves in an early-retirement plan.

Medicare is not free. In 2026 everyone pays the standard Part B premium of $202.90/month per person (plus a $283 annual Part B deductible). On top of Part B you typically add either Original Medicare with a Medigap supplement (national-average Plan G is about $155/month) and a Part D drug plan (the 2026 base premium is $38.99/month), or a Medicare Advantage plan (2026 average about $11/month but with higher, capped out-of-pocket costs). The calculator adds your expected out-of-pocket spend on top of premiums.

IRMAA — the Income-Related Monthly Adjustment Amount — is a surcharge higher-income beneficiaries pay on top of the standard Part B and Part D premiums. It is set by your MAGI from two years prior and rises in brackets: in 2026 it starts above $109,000 (single) / $218,000 (married filing jointly). For steady-state planning this tool applies your entered retirement MAGI directly and shows the implied tier, so you can see when an extra Roth conversion would tip you into a higher surcharge.

An HSA can pay qualified medical costs — deductibles, copays, and coinsurance — tax-free at any age. At 65 and older it can also pay Medicare Part B, Part D, and Medicare Advantage premiums tax-free. It can never be used for Medigap (supplement) premiums, and ACA marketplace premiums generally are not HSA-eligible either. The calculator only draws the HSA against eligible expenses under the drawdown strategy you choose.

Mostly no. US ACA marketplace plans are US-only, and Original Medicare covers almost nothing outside the country. Medigap plans C, D, F, G, M, and N add a limited foreign-travel emergency benefit (80% after a $250 deductible, $50,000 lifetime cap). If you are outside the US 330+ days a year the ACA coverage requirement does not apply. The tool's travel mode lets you add a global/expat premium on top of US coverage, or replace US coverage with it — while still paying Part B at 65+ to avoid late-enrollment penalties.

The headline is the present value in today's dollars — the lump sum you'd need set aside today, earning a conservative real return (about 3% above inflation), to cover every future year of healthcare. That is the number published benchmarks like Fidelity's roughly $345,000-per-couple estimate are quoted in, so it's the fair comparison. Simply adding up decades of inflating premiums produces a much larger figure (often well over a million dollars in future, inflated dollars) that overstates the real burden because those future dollars are worth less and your savings grow in the meantime. The calculator also shows an average cost per year, and the future-dollars toggle if you want to see the raw inflated total — clearly labeled as not comparable to published estimates.

No. If your modified adjusted gross income is below about 138% of the Federal Poverty Level before 65, you would generally qualify for Medicaid (near-free coverage) in states that expanded it, and the calculator models your pre-65 cost near zero. At 65 and older, income below roughly 135% FPL generally qualifies you for a Medicare Savings Program (which pays your Part B premium) plus Part D Extra Help, driving Medicare premiums and cost-sharing close to zero as well. When your income is below these thresholds the tool shows a gold callout and a much lower cost. These are estimates only — eligibility and benefits vary by state, and some states did not expand Medicaid, so confirm on Medicaid.gov and Medicare.gov.

It varies widely with income, location, and health, but the structure is predictable: a subsidized ACA plan in the gap years (often a few hundred dollars a month after the credit, or the full unsubsidized premium if you are over the subsidy cliff), then Part B plus a supplement or Advantage plan plus out-of-pocket once Medicare starts. Run your own numbers above with your real income and area to see your own total.

No. These are planning estimates built from public 2026 figures (CMS, HHS, KFF, and IRS revenue procedures). Marketplace (SLCSP), Medigap, and Medicare Advantage prices vary by area and age and must be confirmed on HealthCare.gov and Medicare.gov. The Federal Poverty Levels used are for the 48 contiguous states — Alaska and Hawaii have higher guidelines this tool does not model.