Think you’ve got enough saved in your HSA? Medicare won't cover these 3 healthcare costs in retirement — and they can top $100,000 a year

Here’s what you need to know about three of the most common (and most expensive) healthcare expenses Medicare won’t cover. Together, they can easily run you six figures a year. Knowing what’s coming, and saving for it now, can make a real difference.

Routine dental care

Many older Americans are surprised to learn that Medicare won’t pay for routine dental care.

How much these services cost can vary a lot depending on your oral health, where you live and the provider you go to.

A standard dental cleaning without insurance runs about $100 to $250, according to Healthinsurance.org. If you have a cavity and need a filling, you can expect to pay between $50 and $150 to restore one or two teeth with dental amalgam. It’s between $90 and $250 to restore one to two teeth using composite resin or glass ionomer material.

Of course, if you require a more involved procedure, the costs will be even higher. The average cost of a root canal is around $1,200. The cost of dentures runs anywhere from $450 to $12,000-plus, depending on the type needed.

Vision exams and care

Medicare doesn’t cover vision care, and that can get pricey. Without insurance, a comprehensive eye exam typically costs $100 to $250, though the price can go higher depending on your provider and location. You can save by going to a retail chain — Walmart Vision Centers start at $65, and Sam’s Club exams start as low as $45.

If you need a new pair of glasses, that could cost you a bundle, too. A complete pair of prescription eyeglasses without insurance typically runs $200 to $600. Costs can vary significantly depending on the frames you choose and the type of lenses you need.

Long-term care

Eventually, you may need some form of long-term care — whether that’s a home health aide to help with daily tasks, an assisted living community, or even a nursing home. Medicare won’t cover these costs because they aren’t considered medical services.

If you have to pay for long-term care needs on your own, these are the yearly costs you may be looking at, according to CareScout’s 2025 Cost of Care Survey:

• $80,076 for a non-medical caregiver (home health aide), based on 44 hours per week
• $74,400 for an assisted living community
• $114,972 for a shared nursing home room
• $129,576 for a private nursing home room

How your HSA can help fill the gap

Since Medicare won’t pay for all of your future healthcare needs, it’s a good idea to contribute to an HSA during your working years and reserve that money for retirement. HSA funds never expire, and any money you contribute and don’t use right away can be invested for tax-free growth.

Fidelity puts the average cost of health care in retirement for a 65-year-old ending their career today at $172,500. This figure accounts for Medicare premiums and out-of-pocket costs as well as expenses Medicare doesn’t cover. However, it doesn’t factor in dental services and long-term care.

It could be a good idea to max out your HSA contributions if you can afford it. In 2026, that means contributing up to $4,400 for individual coverage or $8,750 for family coverage. If you’re 55 or older (and not yet enrolled in Medicare), you can add $1,000 to whichever limit applies to you. Note that HSA limits change from year to year.

This assumes, of course, that your health insurance plan is compatible with an HSA. To qualify this year, you need a minimum $1,700 deductible for individual coverage or $3,400 for family coverage. You also need an out-of-pocket maximum no bigger than $8,500 with individual coverage or $17,000 for family coverage. Like HSA limits, the rules for deductibles and out-of-pocket maximums change annually.