HealthView Services has released its February 2026 report on expected health care costs, including premiums, co-pays and other expenses, for American retirees. The top-line numbers look huge at first, but they are the sum of costs over 25 or more years.
And some of those costs come out of retirees’ Social Security benefits.
The cumulative lifetime cost of health care for retirees varies widely, depending on whether they live in big northern cities or rural areas along the Gulf coast, the inflation rate, and the number of years they live. The size of the surcharges they’ll owe on their Medicare premiums, if any, will depend on their income in retirement. Here are HealthView’s latest findings:
Retirement healthcare cost projections
National average lifetime premiums for Medicare Parts B, D, and supplemental insurance are projected to be a combined $688,996 for a healthy 65-year-old couple retiring in 2026. If deductibles, copays, hearing, vision, and dental are added, total costs could increase to $955,411.
Variance by state
Total lifetime projections for the couple described above range between $878,565 in Washington State and $1,053,252 in Missouri.
Healthcare costs vs. Social Security benefits
HealthView’s Retirement Healthcare Cost Index compares lifetime projected medical expenses and anticipated Social Security benefits. With Social Security cost-of-living adjustments (COLAs) estimated at 2.4% and healthcare costs projected to rise at an average of 5.8%,
A healthy 55-year-old couple (with average Social Security benefits and national average healthcare costs) will need 104% of their benefits to cover medical premiums and out-of-pocket expenses.
A 65-year-old couple will need 84% of Social Security benefits for healthcare
A 45-year-old couple will need 129%
Challenges for women
Women live on average two years longer than men and tend to marry men two years older. Expected lifetime healthcare costs for a healthy 63-year-old woman (retiring at 65, living to age 90) are projected to be $560,325. That’s 27% more than a 65-year-old male (retiring at 65, living to 88) at $442,563.
IRMAA surcharges
Medicare’s Income-Related Monthly Adjustment Amount (IRMAA) policy assigns surcharges to Part B and Part D recipients based on their modified adjusted gross income (MAGI). The estimated lifetime Medicare premiums for a healthy 55-year-old woman are:
- MAGI Less Than $136k: $306,003
- MAGI Between $136k and $169k: $411,498 (34% increase)
- MAGI Between $169k and $212k: $570,587 (86%)
- MAGI Between $212k and $255k: $729,674 (138%)
- MAGI Between $255k and $609k: $888,764 (190%)
- MAGI Above $609k: $941,793 (208%)
End-of-life care
Traditional Medicare premiums and out-of-pocket expenses generally do not address end-of-life long-term care needs, including care in a skilled nursing or assisted living facility or at home.
The national average cost for a year of care in a skilled nursing facility in 2036 is estimated to reach $155,126 by 2036. Cost estimates range from $233,180 in New York State to $111,931 in Texas. The national average cost for a year of home health care (44 hours/week) is expected to reach $141,637 in 2046. Estimates range from $194,664 in Oregon to $81,043 in Louisiana.
© 2026 RIJ Publishing.
