Retirement healthcare cost calculator
Estimate medical costs after you stop working — across the pre-Medicare ACA gap years and the Medicare years — including ACA subsidies, IRMAA surcharges, HSA drawdown, and travel/abroad coverage.
Starting example — set to your age.
Starting example — set to the age you'd stop working.
Default 65 — Medicare eligibility age (CMS). Leave as-is unless you have a special case.
Default 90 — a conservative longevity horizon (above the ~mid-80s U.S. life expectancy at 65, SSA).
Starting example — set to your planned retirement income. Drives both the ACA subsidy and the IRMAA tier.
ACA gap years (pre-65)
Default Silver — the most-chosen tier and the one ACA subsidies are benchmarked to (KFF).
Default Average — premiums vary roughly ±25% by rating area (KFF/CMS).
Estimated from your inputs
Benchmark silver premium: $870/mo · Your silver plan: $870/mo · Deductible: $5,000 · Out-of-pocket max: $8,500
Based on age 55 at FIRE, CMS age rating, and national averages. Switch to exact mode to enter real quotes.
Default 5.5%/yr — recent marketplace premium trend (KFF). Lower to ~4% for a conservative view.
Medicare years (65+)
Part B is automatic and added for you. Everyone pays the 2026 standard Part B premium of $202.90/mo per person (plus a $283 annual deductible), per the CMS 2026 Parts A & B fact sheet. Higher income adds an IRMAA surcharge — your tier is shown in the results. The fields below are the coverage you add on top of Part B.
Default ~$155/mo — 2025 national-average Medigap Plan G; varies by state, age & plan letter. Edit to your premium.
Default ~$40/mo — near the 2026 national base Part D premium ($38.99, CMS); plans range widely. Edit to yours.
Default $6,000 — about the 2026 average Medicare Advantage in-network out-of-pocket (~$5,400; legal cap $9,250, KFF). Medigap users usually pay far less.
Default 5%/yr — long-run Medicare per-capita cost trend (CMS National Health Expenditure data).
Default 3%/yr — roughly the long-run U.S. CPI and the Fed's ~2% target plus headroom.
HSA (optional)
Default 4%/yr — a conservative invested-HSA return. Use ~5–7% if fully invested, ~0–2% if held in cash.
Travel / abroad (optional)
Lifetime net cost (today's dollars)
$456,625
age 55 through 90
Gap years total · 10 yrs
$123,380
ACA coverage before Medicare
Medicare total · 26 yrs
$333,245
from Medicare age on
ACA subsidies captured
$56,150
HSA funds used
$0
At 383% of the Federal Poverty Level, your ACA required contribution is about 9.96% of MAGI toward the benchmark plan, with the rest covered by the premium tax credit.
At your MAGI there's no IRMAA surcharge, so each person pays the standard Part B premium noted in the Medicare inputs above.
Year-by-year breakdown
| Year / Age | Phase | Premium | Subsidy | Out-of-pocket | HSA draw | Net cost |
|---|---|---|---|---|---|---|
| 2031 / 55 | ACA | $6,737 | -$5,029 | $4,312 | — | $11,050 |
| 2032 / 56 | ACA | $6,901 | -$5,151 | $4,417 | — | $11,318 |
| 2033 / 57 | ACA | $7,068 | -$5,276 | $4,524 | — | $11,593 |
| 2034 / 58 | ACA | $7,240 | -$5,404 | $4,634 | — | $11,874 |
| 2035 / 59 | ACA | $7,416 | -$5,535 | $4,746 | — | $12,162 |
| 2036 / 60 | ACA | $7,596 | -$5,669 | $4,862 | — | $12,457 |
| 2037 / 61 | ACA | $7,780 | -$5,807 | $4,980 | — | $12,760 |
| 2038 / 62 | ACA | $7,969 | -$5,948 | $5,101 | — | $13,069 |
| 2039 / 63 | ACA | $8,162 | -$6,092 | $5,224 | — | $13,387 |
| 2040 / 64 | ACA | $8,360 | -$6,240 | $5,351 | — | $13,711 |
| 2041 / 65 | Medicare | $6,371 | — | $3,603 | — | $9,974 |
| 2042 / 66 | Medicare | $6,495 | — | $3,673 | — | $10,168 |
| 2043 / 67 | Medicare | $6,621 | — | $3,744 | — | $10,365 |
| 2044 / 68 | Medicare | $6,750 | — | $3,817 | — | $10,567 |
| 2045 / 69 | Medicare | $6,881 | — | $3,891 | — | $10,772 |
| 2046 / 70 | Medicare | $7,015 | — | $3,966 | — | $10,981 |
| 2047 / 71 | Medicare | $7,151 | — | $4,044 | — | $11,194 |
| 2048 / 72 | Medicare | $7,290 | — | $4,122 | — | $11,412 |
| 2049 / 73 | Medicare | $7,431 | — | $4,202 | — | $11,633 |
| 2050 / 74 | Medicare | $7,575 | — | $4,284 | — | $11,859 |
| 2051 / 75 | Medicare | $7,722 | — | $4,367 | — | $12,089 |
| 2052 / 76 | Medicare | $7,872 | — | $4,452 | — | $12,324 |
| 2053 / 77 | Medicare | $8,025 | — | $4,538 | — | $12,563 |
| 2054 / 78 | Medicare | $8,181 | — | $4,626 | — | $12,807 |
| 2055 / 79 | Medicare | $8,340 | — | $4,716 | — | $13,056 |
| 2056 / 80 | Medicare | $8,502 | — | $4,808 | — | $13,310 |
| 2057 / 81 | Medicare | $8,667 | — | $4,901 | — | $13,568 |
| 2058 / 82 | Medicare | $8,835 | — | $4,996 | — | $13,831 |
| 2059 / 83 | Medicare | $9,007 | — | $5,093 | — | $14,100 |
| 2060 / 84 | Medicare | $9,182 | — | $5,192 | — | $14,374 |
| 2061 / 85 | Medicare | $9,360 | — | $5,293 | — | $14,653 |
| 2062 / 86 | Medicare | $9,542 | — | $5,396 | — | $14,937 |
| 2063 / 87 | Medicare | $9,727 | — | $5,500 | — | $15,227 |
| 2064 / 88 | Medicare | $9,916 | — | $5,607 | — | $15,523 |
| 2065 / 89 | Medicare | $10,108 | — | $5,716 | — | $15,825 |
| 2066 / 90 | Medicare | $10,305 | — | $5,827 | — | $16,132 |
Planning estimates only. Not financial, tax, or legal advice.
Health insurance and Medicare costs in early retirement
Health insurance is one of the biggest unknowns of retiring before 65. Once employer coverage ends you have to bridge the years until Medicare on your own — usually with an Affordable Care Act (ACA) marketplace plan — and then keep paying for Medicare and its gaps for the rest of your life. This calculator estimates both stages so you can see what healthcare really adds to an early-retirement plan.
For the pre-65 gap years it models your ACA premium after the premium tax credit (subsidy), the 2026 return of the 400%-of-poverty subsidy cliff, your expected out-of-pocket spend, and how an HSA can help. For the Medicare years it models the 2026 standard Part B premium, income-related IRMAA surcharges, and either Medigap plus Part D or a Medicare Advantage plan — with an option for travel and abroad coverage on top.
Every prefilled number is a sourced 2026 (or latest published) national figure shown right at the field, so you can trust the starting point and then replace it with your own quotes from HealthCare.gov and Medicare.gov. These are planning estimates, not official quotes.
Questions & answers
How much does health insurance cost before Medicare?
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.
What is the ACA subsidy and who qualifies?
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.
What is the 400% FPL subsidy cliff in 2026?
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.
What does Medicare actually cost at 65?
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.
What is IRMAA and how is it calculated?
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.
Can an HSA pay my Medicare premiums?
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.
Does US health coverage work if I travel or retire abroad?
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.
How much should I budget for healthcare in early retirement?
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, and view the lifetime total in today's or future dollars to see healthcare's true bite on the plan.
Are these healthcare cost figures official?
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.