You hit on the only San Diego negatives: Lack of nearby cruising choices and the high cost of living. I think San Diego is a far superior place to live, overall. Also, Oriental is at least an hour from the decent sized hospital, in New Bern. Aging people need to think about access to healthcare.

Another option is inland New England. You could keep your boat less than 60 minutes away and have the same wonderful views those megabucks mansions have (see image below). (30 minutes away puts you in some rural areas, but to get lower RE prices you don't even need to be inland by more than a few miles. Onset MA would be coastal New England and give you access to the Cape Cod and Boston metro areas, also Buzzards Bay and Block Island/Martha's Vineyard the Rhode Island coast (Narragansett Bay, Newport etc.). Any one of those areas has far more character, charm and cultural interest than all of NC put together.

Or you could go just a few miles inland anywhere between Groton CT and Newport RI and keep your boat in Mystic, Stonington CT. That might be my plan... A move to Stonington but go inland a bit where the area feels rural, but still be within 20 minutes of my boat on its mooring and a regional hospital. Stonington CT is my favorite harbor. Can't think of anywhere I'd rather be, except in Winter. But in winter, I'd want to be further south than NC. Maybe Charleston SC or someplace in Georgia.

Ahhh -- Maybe snowbirds have it right... Buy a trawler or big sailboat (one with a washer/dryer and genset with AC) and be where you want to be at the moment.