Those figures do not include co-pays, dental, vision, hearing and other out-of-pocket medical expenses, which the report says will all conspire to increase costs dramatically: all in, the couple retiring this year will spend an average of $394,954; the couple retiring in 10 years can expect to pay $463,849.

Year-over-year inflation rates are projected to average 6.5 percent. None of the estimates attempt to account for long-term care services.

For the couple retiring today, health care costs will eat up about 67 percent of the average couple’s lifetime Social Security benefits. Ten years from now, that figure is projected to be 90 percent, according to the report.

“While wealthier Americans have other sources of income to draw upon, middle class Americans with more modest savings are likely to face difficult choices unless they have planned ahead,” said Ron Mastrogiovanni, CEO of HealthView Services, a Massachusetts-based provider of health care cost projection software.

Planning for those costs needs to happen at the individual level, as factors like gender, and even where someone lives, impact health care cost expectations, the company said.

And while that healthy couple retiring today could reasonably be expected to pay less in health care costs, its latest data found the reverse to be true.

For example, total retirement health care costs for a 55-year old male with Type II diabetes living in Illinois are expected to be $118,000, considerably less than his healthy counterpart, whose costs are expected to be $223,000, due to a longer life expectancy.

Longevity, and increased mortality expectations, come with a trade-off, said the report. HealthView’s data shows that an average 55-year-old couple that lives two years beyond their average life expectancy will incur an additional $57,353 in total retirement health care costs.

While the report’s projections are daunting, Mastrogiovanni said they are manageable, “if planned for early enough.”

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“The starting point for managing these costs is sitting down with an advisor to calculate expected health care costs and incorporating them into a comprehensive retirement plan," he said.

By saving $429 a month for 10 years, the average 55-year-old couple can generate enough savings to cover Medicare Part D costs, the report said.

By saving $1,206 a month, the same couple could cover Medicare Part D and the cost of supplemental insurance premiums, assuming a 6 percent return on investment.