St. Louis vs Sioux Falls for Retirees (2026)
Scroll down for retirement income tax breakdown, healthcare estimates, and FAQ.
Full retirement cost breakdown
| Metric | St. Louis Missouri | Sioux Falls South Dakota |
|---|---|---|
| 1BR rent / month | $1,300 | $1,250Better |
| Median home price | $230KBetter | $265K |
| State income tax | 4.7% | NoneBetter |
| Sales tax (combined) | 8.6% | 6.4%Better |
| Monthly utilities | $162 | $155Better |
| Groceries index (US = 100) | 97 | 96Better |
| Est. healthcare / month | $435Better | $440 |
| Walk score (0–100) | 61 / 100Better | 26 / 100 |
| Overall COL index (100 = US avg) | 87Better | 88 |
Frequently asked questions
Which city is better for retirement — St. Louis or Sioux Falls?
Based on home prices, taxes on retirement income, walkability, and overall cost of living, St. Louis scores better for retirees. Median home prices are $230K in St. Louis vs $265K in Sioux Falls. St. Louis is approximately 1% cheaper overall. The best choice still depends on climate, healthcare access, and proximity to family.
Is retirement income taxed in St. Louis or Sioux Falls?
South Dakota has no state income tax, meaning Social Security, pension, and retirement account withdrawals are not subject to state tax. Missouri has a 4.7% state income tax rate. For retirees, this difference can save thousands annually.
What is the estimated monthly healthcare cost in St. Louis vs Sioux Falls?
Based on national average retiree healthcare spending (~$500/month) scaled by each city's cost-of-living index, estimated monthly healthcare costs are approximately $435 in St. Louis and $440 in Sioux Falls. That's a difference of ~$5/month, or ~$60/year. Actual costs vary based on your Medicare plan, supplements, and health needs.
Can I afford to retire in St. Louis on a $50,000 annual income?
On a $50,000/year ($4,167/month) retirement income in St. Louis, rent alone would consume approximately 31% of your budget (1BR rent ~$1,300/mo) and healthcare another ~10%. That leaves roughly 59% (~$2,458/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?
St. Louis has a higher walk score (61 vs 26 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. St. Louis offers more independence without a car, which also reduces transportation costs.
$50K/year in St. Louis has the same purchasing power as $51K/year in Sioux Falls
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