San Francisco vs St. Louis for Retirees (2026)
Scroll down for retirement income tax breakdown, healthcare estimates, and FAQ.
Full retirement cost breakdown
| Metric | San Francisco California | St. Louis Missouri |
|---|---|---|
| 1BR rent / month | $3,600 | $1,300Better |
| Median home price | $1.2M | $230KBetter |
| State income tax | 9.3% | 4.7%Better |
| Sales tax (combined) | 8.6%Better | 8.6% |
| Monthly utilities | $160Better | $162 |
| Groceries index (US = 100) | 118 | 97Better |
| Est. healthcare / month | $970 | $435Better |
| Walk score (0–100) | 87 / 100Better | 61 / 100 |
| Overall COL index (100 = US avg) | 194 | 87Better |
Frequently asked questions
Which city is better for retirement — San Francisco or St. Louis?
Based on home prices, taxes on retirement income, walkability, and overall cost of living, St. Louis scores better for retirees. Median home prices are $1.2M in San Francisco vs $230K in St. Louis. St. Louis is approximately 55% cheaper overall. The best choice still depends on climate, healthcare access, and proximity to family.
Is retirement income taxed in San Francisco or St. Louis?
St. Louis has the lower state income tax rate (4.7% vs 9.3%). Note that many states exempt Social Security income and some pension income from state taxes even when other income is taxed — check your specific state's retirement tax rules.
What is the estimated monthly healthcare cost in San Francisco vs St. Louis?
Based on national average retiree healthcare spending (~$500/month) scaled by each city's cost-of-living index, estimated monthly healthcare costs are approximately $970 in San Francisco and $435 in St. Louis. That's a difference of ~$535/month, or ~$6,420/year. Actual costs vary based on your Medicare plan, supplements, and health needs.
Can I afford to retire in San Francisco on a $50,000 annual income?
On a $50,000/year ($4,167/month) retirement income in San Francisco, rent alone would consume approximately 86% of your budget (1BR rent ~$3,600/mo) and healthcare another ~23%. That leaves roughly -9% (~$-375/mo) for groceries, transportation, and other expenses. This is tight — a studio apartment or lower-cost neighborhood would help.
Which city is more walkable for retirees?
San Francisco has a higher walk score (87 vs 61 out of 100). Walkability is increasingly important for retirees who want to reduce car dependence — a score above 70 means most daily errands can be done on foot. San Francisco offers more independence without a car, which also reduces transportation costs.
$50K/year in San Francisco has the same purchasing power as $22K/year in St. Louis
Healthcare estimates based on national avg retiree spending (~$500/mo) scaled by COL index · State income tax rates from Tax Foundation · Data: Zillow, BLS, Numbeo · Q1 2026