Healthcare is the single largest unplanned expense in retirement. A 65-year-old couple retiring in 2026 can expect to spend an estimated $315,000 on healthcare over retirement — not counting long-term care. Understanding Medicare and maximizing your HSA before retirement are the two highest-leverage healthcare planning moves available.
Medicare Explained
Medicare is the federal health insurance program for Americans 65 and older. It has four main parts covering different services.
| Part | What It Covers | 2026 Cost |
|---|---|---|
| Part A (Hospital) | Inpatient hospital, skilled nursing, hospice | $0 premium if 40+ work quarters |
| Part B (Medical) | Doctor visits, outpatient, preventive care | $185/month standard premium |
| Part C (Advantage) | All-in-one private alternative to A+B | Varies; many plans $0 premium |
| Part D (Drugs) | Prescription drugs | Varies; avg ~$46/month |
| Medigap | Fills Part A+B coverage gaps | Typically $100–$300/month |
- Medicare Explained: Parts A, B, C, D and What They Cost — the complete breakdown with 2026 premiums, deductibles, and coinsurance figures
- Financial Things to Do Before 65 — a pre-retirement Medicare checklist covering enrollment timing, HSA strategy, and IRMAA planning
Medicare Advantage vs. Original Medicare
The most important Medicare decision is whether to use Original Medicare (with or without a Medigap supplement) or switch to a Medicare Advantage plan.
| Factor | Original Medicare + Medigap | Medicare Advantage |
|---|---|---|
| Provider network | Nationwide, nearly unlimited | Restricted to plan network |
| Out-of-pocket maximum | No cap (Medigap fills the gap) | Capped (typically $3,500–$8,850) |
| Monthly premiums | Higher (Part B + Medigap) | Often lower ($0–$50/month) |
| Dental/vision extras | Not included | Often included |
| Best for | Frequent travelers, complex health needs | Healthy retirees staying local |
- Medicare Advantage vs. Original Medicare: Which Is Better? — side-by-side analysis for different situations
- Medigap vs. Medicare Advantage: Which Supplement Is Better? — when each option makes financial sense
- Best Medicare Advantage Plans of 2026 — top-rated plans by state with cost and coverage data
- Best Medigap Plans of 2026 — Plan G vs. Plan N compared with premium ranges
- Medicare vs. Medicaid: What Is the Difference? — who qualifies for each and how they interact
HSA: The Triple-Tax-Advantaged Retirement Account
A Health Savings Account (HSA) is the most tax-efficient account in the U.S. tax code. Contributions are pre-tax, growth is tax-free, and withdrawals for qualifying medical expenses are tax-free. After 65, you can withdraw for any reason — making an HSA function like a traditional IRA with an added medical spending bonus.
The 2026 HSA contribution limits are $4,300 for individual HDHP coverage and $8,550 for family coverage, with a $1,000 catch-up contribution available at age 55+.
- Best HSA Accounts of 2026 — top providers compared by investment fees, fund selection, and account minimums
- HSA Calculator — project how much your HSA will grow by retirement
- How to Choose an HSA Provider — what to look for in fees, investment menus, and FDIC vs. brokerage options
- Average HSA Balance by Age — see how your balance compares to peers
Retirement Healthcare Costs and Early Retirement
- Healthcare Costs in Retirement: What to Budget — realistic projections by health status, showing how costs compound over a 20–30 year retirement
- Early Retirement Healthcare: How to Get Insurance Before 65 — ACA marketplace, COBRA, spouse coverage, and HSA bridge strategies for retirees under 65
Medicare & HSA Articles
Medicare explained
- Medicare Explained: Parts A, B, C, D and Costs
- Medicare Advantage vs Original Medicare
- Best Medicare Advantage Plans of 2026
- Medigap vs Medicare Advantage
- Best Medigap Plans of 2026
- Medicare vs Medicaid: What’s the Difference?
Healthcare costs and planning
- Healthcare Costs in Retirement
- Early Retirement Healthcare: Coverage Before Medicare
- Financial Things to Do Before 65
HSA accounts
See parent hub: Retirement
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