Marriage & Medicare: What You Need to Know
Key Takeaways
Married couples’ joint incomes and work histories help determine how much they pay for Part B premiums . Medicare Part A is provided at no cost for eligible enrollees.
Married couples also may qualify for Special Enrollment Periods based on Qualifying Life Events like losing employer/spouse coverage or moving.
How Does Being Married Affect Medicare Costs?
Being married means you and your spouse’s joint income and work histories will be considered in some circumstances. Usually, they’re used to determine the separate cost for each plan. Here’s how it works:
Your Part A premiums
You and your spouse’s monthly Part A premiums are based on how long you paid Medicare taxes while employed. If neither of you worked at least 10 years, you might have to pay for your Part A premium. For 2024, if you or your spouse paid Medicare taxes for:
- At least 10 years: $0 per mo.
- Fewer than 10 years but more than 7.5: $278 per mo.
- Fewer than 7.5 years: $505 per mo.
Your Part B premiums
All part B premiums start at the same amount for every individual. In 2024, it’s $174.70 per month. That monthly payment amount can increase depending on your income. This rate increase is called an Income-Related Monthly Adjustment Amount (IRMAA). The higher your income, the greater the IRMAA you will need to pay for your Part B premium.
The IRMAA rates for 2024 are:
Annual income: Individual (up to $103,000) & Joint (up to $206,000)
- IRMAA: $0
- Part B premium: $174.70
Annual income: Individual ($103,000 to $129,000) & Joint ($206,000 to $258,000)
- IRMAA: $69.90
- Part B premium: $244.60
Annual income: Individual ($129,000 to $161,000) & Joint ($258,000 to $322,000)
- IRMAA: $174.70
- Part B premium: $349.40
Annual income: Individual ($161,000 to $193,000) & Joint ($322,000 to $386,000)
- IRMAA: $279.50
- Part B premium: $454.20
Annual income: Individual ($193,000 to $500,000) & Joint ($386,000 to $750,000)
- IRMAA: $384.30
- Part B premium: $559
Annual income: Individual ($500,000 and above) & Joint ($750,000 and above)
- IRMAA: $419.30
- Part B premium: $594
How Does Being Married Affect Medicare Enrollment?
Being married also may affect how you enroll in Medicare. While each beneficiary will enroll when they turn 65, in some instances, being married may grant you additional enrollment opportunities. These are known as Special Enrollment Periods and can apply if:
- You or your spouse lose your job-based coverage
- You lose coverage because your spouse dies
- You move to a different area
- And more
Does Medicare Recognize Same-Sex Married Couples?
Yes. In 2013, the Supreme Court repealed a vital portion of the Defense of Marriage Act, clearing the way for same-sex married couples to enjoy the same protections as other Americans. That includes access access to federal programs such as Medicaid, Children’s Health Insurance Program (CHIP), and Medicare.
Being in a marriage of any kind won’t affect which type of Medicare you enroll in — Original Medicare (Parts A and B) and Medicare Advantage only offer individual plans. That means you and your spouse can’t enroll in a family plan together. But marriage impacts each of your plans when it comes to cost and timing.
