Retirement Health Care Cost Calculator: Plan for Medical Costs

$185,500. Fidelity estimates that's what one person retiring at 65 in 2026 can expect to spend on health care over retirement, and it still leaves out long-term care. For a couple, the figure is about $371,000. If you're looking for a retirement health care cost calculator, start with that number. Then ask the more useful question: what happens to your plan if your costs come in above average?

This guide covers what the main estimates include, the 2026 Medicare numbers to use, the gaps most calculators skip, and how to treat health care as a cost your plan has to carry every year.

Source: Fidelity Investments 2026 Retiree Health Care Cost Estimate, as reported by TheStreet and Fox Business, 2026.

The short answer: what a retirement health care cost calculator should tell you

Most calculators ask for a few inputs and give back one dollar total. Common inputs are:

• Your current age and the age you plan to retire
• Your health status, or specific conditions
• Whether you're single or planning for a spouse too
• Your coverage choice, if the tool asks
• Life expectancy

That total is a reasonable place to start. It isn't a plan. A good estimate should tell you three things:

1. The likely range, not just one figure.
2. How that cost changes your odds of your savings lasting.
3. What it leaves out, so you know where the risks sit.

Most tools only give you the first, and only as a single number.

What the headline numbers include and leave out

Fidelity's estimate is the one people quote most. Its 2026 figure is 7.5% higher than the $172,500 it published in 2025. Here's what that number covers.

So $185,500 is a floor for some households, not a ceiling. If you expect regular dental work, or you want room for care at home or in a facility, the real number in your plan has to be higher.

Source: Fidelity 2026 estimate, as summarized by TheStreet and Yahoo Finance, 2026.

Why one number isn't enough: think in odds

An average works for a group of people. You'll live only one retirement, and it could cost more than average.

The Employee Benefit Research Institute (EBRI) approaches this differently. Instead of one total, it estimates how much you'd need saved for a 50% chance or a 90% chance of covering health care costs in retirement.

The gap between those two answers is large:

• A man on Medicare Advantage with median drug costs needs about $61,000 for a 50% chance, and about $106,000 for a 90% chance.
• A couple with high prescription drug costs needs $469,000 for a 90% chance. The previous edition's headline figure was $428,000.
• At the same 90% threshold, EBRI puts the figure at $212,000 for a man and $252,000 for a woman.

EBRI says these savings targets also exclude long-term care.

Source: EBRI Issue Brief, March 2026 edition; see also BenefitsPRO, Mar 2026.

Look at the jump from 50% to 90%. Saving enough to cover health care "on average" works out to roughly a coin flip. Most people planning retirement want odds much better than that.

This is how Monte Carlo planning works too. A Monte Carlo simulation runs your plan through many possible futures, each with different market returns and different sequences of good and bad years. It counts how many of those futures still have money left at the end. You get a probability, not a promise.

2026 Medicare costs to plug into any calculator

Many calculators run on older data. One widely used free tool dates from 2013. Others start from Fidelity's 2023 base figure. If you're entering your own numbers, use the 2026 figures:

• Medicare Part B standard premium: $202.90 a month, up 9.7% from $185.00 in 2025.
• Part B annual deductible: $283, up from $257.

Sources: LACERS, Medicare Part B Premium for 2026; Current Federal Tax Developments, 2026 Adjustments to Medicare Parts A, B, and D, Nov 2025.

Premiums don't stay fixed. Each year's increase builds on the last, so a calculator that uses one flat annual cost for 30 years will usually understate the total.

The gaps most calculators miss

The tools that rank for this search do one job: they produce a total. The things below can matter as much as that total.

Health care before 65

Fidelity's estimate starts at 65 because that's when Medicare begins. If you retire at 62, you need to pay for coverage for three years before then, often through an ACA marketplace plan. That cost comes straight out of your savings in the early years, before Social Security and Medicare are fully in place. Most calculators hardly mention it.

IRMAA and how you withdraw money

IRMAA (the Income-Related Monthly Adjustment Amount) is a surcharge added to Medicare Part B and Part D premiums for higher-income retirees. It uses your income from two years earlier. Your 2026 premiums are based on your 2024 income. The top bracket starts at $500,000 for single filers and $750,000 for married couples filing jointly.

Source: Federal Pension Advisors, 2026 Medicare IRMAA Brackets, 2026.

In practice, a large one-time withdrawal or a Roth conversion can raise your Medicare premiums two years later. How you take money out affects what health care costs you. A standalone health cost calculator can't show this, because it doesn't know your withdrawal plan.

Long-term care

Both Fidelity and EBRI leave it out. Long-term care can mean help at home, assisted living, or nursing care. It's a real possibility for many retirees and it can be expensive. Even if you don't build a dedicated fund for it, test what happens to your plan if you need it.

Medigap vs. Medicare Advantage

EBRI's results show that your coverage choice changes the savings target a lot. Medigap (supplemental insurance that sits alongside Original Medicare) and Medicare Advantage (private plans that replace it) have very different premium and out-of-pocket patterns. Few calculators ask you which one you'll choose.

Living longer than you planned

Each extra year adds a year of premiums. Social Security's planning guidance says about one in three 65-year-olds may live to at least 90. A plan that ends at 85 quietly bets against a third of retirees.

Source: Social Security Administration, Retirement Information for Medicare Beneficiaries, 2026.

How to build health care into your retirement plan

You don't need perfect numbers. You need honest ones, tested against bad outcomes.

1. Start with your monthly spending. EBRI's 2025 Retirement Confidence Survey found only 52% of workers have estimated the monthly income they'll need in retirement. The other 48% are guessing. Make sure your monthly figure includes premiums, deductibles and expected out-of-pocket costs. (Source: EBRI/Greenwald Retirement Confidence Survey 2025, Fact Sheet 3.)

2. Add the years before Medicare. If you plan to retire before 65, count bridge coverage as its own expense.

3. Model health care year by year, not as one total. A lump sum hides the timing. Premiums arrive every month, rise over time, and can jump when IRMAA applies.

4. Plan to 95, not 85. Longevity is a health care risk as much as a market risk.

5. Stress-test the unlikely cases. What if your drug costs are high? What if you need long-term care at 82? What if a big withdrawal in one year triggers a surcharge two years later? Break your plan on purpose, before life does.

6. Check your withdrawal rate alongside health costs. Morningstar's 2025 research puts the safe starting withdrawal rate at 3.9%, judged by whether money is still there in 90% of simulated outcomes over a 30-year retirement. Higher health spending pushes your effective withdrawal rate up. (Source: Morningstar, The State of Retirement Income 2025, Dec 2025.)

Where Monte Climb fits

A health care cost calculator answers "how much?" The bigger question is "will my money last if health care costs that much?"

That's the question we built Monte Climb to answer. You enter three numbers: your age, what you've saved, and what you spend each month. We run them through 1,000 simulated futures and give you a success rate. Instead of a flat guess, the engine charges Medicare premiums and income-based surcharges year by year. Plans run to 95 by default, and you can extend them.

If you want to dig in, ask William, our AI planner. Try questions like "Am I on track?", "Can I retire at 62?" or "What's a sustainable amount to spend?" He shows his work. The calculator runs in your browser, and nothing is saved until you choose to save it.

It's planning software, not advice. It's a clear, evidence-based starting point for a decision only you can make.

Run your own numbers

Fidelity's $185,500 is someone else's average. Your number depends on when you retire, how long you live, how you withdraw, and what care you end up needing. Enter your three numbers and see how many of 1,000 futures stay funded.

Show my answer →

Frequently asked questions

How much should I budget for health care in retirement?

Fidelity's 2026 estimate is $185,500 for one person retiring at 65, or about $371,000 for a couple. That covers Medicare premiums, deductibles and prescriptions, but not long-term care, over-the-counter drugs or most dental. EBRI's research shows that for a 90% chance of covering costs, some households need much more. A couple with high drug costs needs $469,000.

What does a retirement health care cost calculator usually leave out?

Most leave out long-term care, coverage costs before Medicare starts at 65, and the IRMAA surcharges that large withdrawals or Roth conversions can trigger two years later. Many also don't ask whether you'll choose Medigap or Medicare Advantage, and some still use data that is several years old.

What is the Medicare Part B premium in 2026?

The standard Medicare Part B premium for 2026 is $202.90 a month, up 9.7% from $185.00 in 2025. The annual Part B deductible is $283, up from $257. Higher-income retirees pay more through IRMAA surcharges.

How does IRMAA affect retirement health care costs?

IRMAA adds a surcharge to Medicare Part B and Part D premiums based on your income from two years earlier. Your 2026 premiums are based on 2024 income. A large withdrawal or Roth conversion in one year can raise your Medicare premiums two years later, so your withdrawal plan and your health costs are linked.

Why is a probability better than one health care cost estimate?

An average describes a group, and your own costs could be higher. EBRI shows the gap: a man on Medicare Advantage with median drug costs needs about $61,000 for a 50% chance of covering costs, but $106,000 for a 90% chance. A success rate across many simulated futures shows how likely your savings are to last.