12. Lexington, Ky.
Annual Healthcare Spending Per Capita: $4,465
Annual Out-of-Pocket Spending Per Capita: $902
Income of Age 65+ Households: $49,214
Lexington is notable for having relatively high out-of-pocket healthcare costs compared to other cities on this list. The $902 spent on average represents 20.2 percent of the total annual healthcare bill for the typical resident, the highest percentage of any city in this study. However, Lexington is still one of the cheapest places to retire across middle America despite those higher out-of-pocket costs.