Does IRMAA Apply to Both Spouses?

The Income-Related Monthly Adjustment Amount (IRMAA) is an additional charge applied to Medicare Part B and Part D premiums for individuals with higher incomes, ensuring they contribute more towards healthcare costs. The Social Security Administration (SSA) determines who pays IRMAA based on income reported to the Internal Revenue Service (IRS). This article clarifies how IRMAA applies to married individuals, considering various tax filing statuses.

Understanding IRMAA Basics

IRMAA is determined by a specific calculation of Modified Adjusted Gross Income (MAGI), which differs from the standard Adjusted Gross Income (AGI) found on a tax return. To calculate MAGI for IRMAA purposes, an individual’s AGI is combined with tax-exempt interest income. Common income sources contributing to AGI, and thus MAGI, include IRA withdrawals, capital gains, dividends, interest from certificates of deposit (CDs), and the taxable portion of Social Security benefits.

The SSA uses income information from tax returns filed two years prior to the current Medicare year to determine IRMAA applicability. For example, the IRMAA for 2025 Medicare premiums is based on income reported on 2023 tax returns. If an individual’s MAGI exceeds certain thresholds, they are assessed an additional premium for both Medicare Part B and Part D. For 2025, an individual filing singly will pay IRMAA if their 2023 MAGI was above $106,000.

IRMAA and Marital Status

The application of IRMAA to married couples depends significantly on their tax filing status. This distinction influences whether each spouse’s income is considered individually or jointly for the surcharge determination. The income thresholds for married couples are typically double those for single individuals.

For couples who file their taxes as Married Filing Jointly, their combined Modified Adjusted Gross Income (MAGI) is used to determine IRMAA for both spouses. Both individuals are generally placed in the same IRMAA tier. For 2025, married couples filing jointly will incur an IRMAA surcharge if their 2023 combined MAGI exceeded $212,000. If a couple’s income crosses a threshold by even a small amount, both individuals will face the higher premium.

When a married couple files taxes as Married Filing Separately, the IRMAA determination has two scenarios. If the spouses lived together at any point during the tax year, both individuals’ incomes are combined for IRMAA purposes, and they are typically assigned to the highest IRMAA tier. This can result in a substantially higher premium for each spouse compared to filing jointly. However, if the married couple lived apart for the entire tax year, each spouse’s individual MAGI is used to determine their respective IRMAA, applying the single filer income thresholds. For 2025, married individuals filing separately will face IRMAA if their 2023 individual MAGI exceeded $106,000.

Life-Changing Events and IRMAA Reconsideration

Individuals or couples may experience life-changing events that significantly reduce their income, potentially qualifying them for an adjustment to their IRMAA. The Social Security Administration (SSA) recognizes specific categories of such events:

• Marriage
• Divorce or annulment
• Death of a spouse
• Work stoppage or reduction
• Loss of income-producing property
• Loss of an employer pension
• Receipt of a settlement payment

To request a new IRMAA determination based on a qualifying life-changing event, individuals must complete and submit Form SSA-44, titled “Medicare Income-Related Monthly Adjustment Amount – Life-Changing Event.” This form allows the SSA to consider more recent income information than the standard two-year look-back period. Along with the completed form, supporting documentation must be provided, such as proof of the life event and estimates of current income.

After submitting Form SSA-44 and the required documentation, the SSA reviews the request. The agency then issues a new determination, notifying the individual of any adjustment to their IRMAA. The process aims to ensure that Medicare premiums accurately reflect a beneficiary’s current financial circumstances following an unforeseen income reduction.