Strong healthcare planning does not begin with a national average. It begins with your coverage, doctors, prescriptions, tax return, family, and retirement life.

Why one national number is not a retirement plan

A published average can be useful as a reminder that healthcare deserves a place in the budget. It cannot tell you what your family will spend. It does not know whether you are still covered by an employer, approaching Medicare eligibility, already enrolled in Medicare or spending part of each year outside Florida. It does not know which specialists you want to keep, which prescriptions you take, whether your income may trigger IRMAA, or how your family would respond to a long period of care. The 2026 Retirement Confidence Survey from the Employee Benefit Research Institute and Greenwald Research underscores the concern. Two in five retirees reported that healthcare expenses in retirement were higher than expected, and fewer than half of workers and retirees said they had calculated how much they might need for healthcare. Those are national survey findings—not a forecast for a Naples family—but they make one point clearly: hoping Medicare will cover everything is not a plan.

What Medicare covers—and where the gaps begin

At a high level, Medicare Part A generally helps cover inpatient hospital care and certain limited skilled nursing, hospice and home-health services. Part B generally helps cover physician services, outpatient care, preventive care and other medically necessary services. Part D provides prescription-drug coverage through private plans. Premiums, deductibles, copayments and coinsurance may still apply. Original Medicare generally does not cover most routine dental care, routine eye exams and eyeglasses, hearing aids, or most long-term custodial care. Limited exceptions can apply, which is why actual coverage decisions should be confirmed through Medicare and a licensed insurance professional. The practical lesson is not that Medicare is inadequate. It is that Medicare is a foundation, not the entire healthcare budget. A retirement plan should allow for the premiums and gaps that remain— along with the possibility that some costs will be irregular rather than monthly.

Medigap or Medicare Advantage? Start with how you live

Many retirees eventually choose between two broad structures: Original Medicare with a Medigap policy and usually a separate Part D plan, or a Medicare Advantage plan offered through a private insurer.

Original Medicare with Medigap may appeal to families who value broader access to providers who accept Medicare and who travel or divide their time between states. Medicare Advantage plans may offer different premiums, cost-sharing, provider networks, out-of-pocket limits and supplemental benefits. Prior authorization and network rules can matter. Neither structure is automatically better. A Naples couple who spends summers elsewhere may evaluate networks differently from a year-round resident. A family with a long-standing relationship with a particular specialist may begin with provider access. Another household may place more weight on premiums, predictable cost-sharing or additional benefits. This is a coverage decision to make with a licensed insurance professional. Our role is to help ensure that the decision is not made in isolation from cash flow, taxes, portfolio withdrawals and the retirement lifestyle you are trying to protect.

IRMAA: when a tax decision becomes a Medicare decision

For affluent retirees, healthcare planning and tax planning often meet at IRMAA—the income-related monthly adjustment amount added to Medicare Part B and Part D premiums for higher-income beneficiaries. Social Security generally determines IRMAA using modified adjusted gross income from the most recent federal tax return the IRS provides, typically from two years earlier. That means a large IRA withdrawal, Roth conversion or realized capital gain this year may affect Medicare premiums later. This does not mean every family should avoid a Roth conversion or refuse to realize a gain. A decision that raises Medicare premiums may still improve the larger retirement plan. The point is to see the tradeoff before the year closes—not after a higher premium notice arrives. If income falls because of a qualifying life-changing event, such as retirement, reduced work, divorce or the death of a spouse, Social Security may permit a new determination when its rules and documentation requirements are met. Your CPA and Social Security should be involved in evaluating the specific situation. The surviving-spouse question matters here as well. After one spouse dies, the survivor may move from a joint to a single tax return. Similar income can then produce a very different tax and Medicarepremium picture. Good planning considers the person who may one day be managing the plan alone.

Long-term care is a family and funding question

Long-term care is often the largest unknown—not because every family will face the same cost, but because the need can arrive suddenly and last longer than expected.

The most useful conversation begins with practical questions: Who would help? Would care be provided at home or in a community? Which accounts would fund it? What would larger withdrawals do to taxes and IRMAA? How would the healthy spouse continue living? What role, if any, should insurance play? Some families choose to self-fund. Some use traditional or hybrid long-term-care insurance. Others expect a combination of family support and paid care. There is no universal answer, and this article is not recommending a policy or carrier. What matters is that the funding plan, family plan and survivor plan are discussed before an urgent event forces all three decisions at once.

Put healthcare inside the retirement paycheck

Healthcare premiums and out-of-pocket costs are retirement spending. They belong inside the income plan—not in a separate column that everyone hopes Medicare will erase. Which account pays those bills can also matter. A traditional IRA withdrawal, a taxable-account sale and a qualified Roth distribution can affect the tax return differently. The portfolio must still maintain appropriate liquidity, diversification and risk management while supporting regular distributions and occasional larger expenses. That is why healthcare planning connects to the other questions retirees are already asking: How much can we comfortably spend? When should we claim Social Security? Should we convert part of an IRA to a Roth? Which accounts should we draw from first? What happens when one spouse is no longer here? These are not separate decisions. They are parts of one retirement life.

What coordinated retirement guidance looks like at Edwards Asset Management

At Edwards Asset Management, we begin with the life your wealth needs to support. We then coordinate the people and disciplines required to help carry out the plan. Each PIM investment-management relationship is supported by a dedicated advisor, a CFP® planning professional, our investment-management team and an experienced client service associate. Together, that team can help connect healthcare costs and coverage decisions with retirement spending, Social Security, portfolio distributions, taxes, estate considerations and the needs of a surviving spouse. Our CFP® professionals use advanced planning technology to model different assumptions for inflation, longevity, withdrawals, Roth conversions, required minimum distributions, Medicare

premiums and survivor income. The software does not predict the future. It helps make the tradeoffs visible, so the plan can be reviewed with your CPA, attorney and licensed insurance professional where their expertise is required. Our investment-management team can then manage the portfolio in coordination with the plan— maintaining appropriate cash reserves and distributions and, when suitable, using tax-aware techniques such as the timing of gains and losses. Sometimes thoughtful planning calls for recognizing more income intentionally. At other times, it may favor deferring income. The right answer depends on the complete picture.

A calm plan for a question that feels uncertain

Healthcare may never become perfectly predictable. Retirement planning does not require perfect prediction. It requires a thoughtful range of assumptions, adequate reserves, coordinated professional advice and a plan that can adjust as health, markets, tax laws and family circumstances change. You do not need to arrive with the healthcare number already solved. Bring your current coverage, what you pay today, your latest tax return and the spending level you hope to maintain. We can help place those facts inside the rest of your retirement plan and identify the questions to take to your CPA and licensed insurance professional. The goal is not simply to pay the lowest premium this year. It is to help your income, investments, taxes, healthcare and family responsibilities work together—so you can live the retirement you worked hard to create with greater clarity and confidence.