Do both spouses pay IRMAA?
Yes, whenever both are enrolled in Medicare. There is no household premium; Medicare prices each beneficiary on their own, so a married couple gets two premium bills and, above the thresholds, two surcharges. The tier itself comes from one shared number. A couple whose 2024 joint MAGI is above $218,000 both sit in 2026's first tier, and the pair of surcharges works out to 2 x ($81.20 + $14.50) x 12, or $2,296.80 for the year. A spouse who is not yet on Medicare owes no premium at all, but that spouse's income still counts, because the joint return cannot be split.
What if only one spouse is on Medicare?
Then only one surcharge exists, and the couple's whole income drives it. Premiums attach to enrollment, so a 62-year-old spouse still working owes Medicare nothing. Their salary, though, is folded into the couple's adjusted gross income, and AGI plus tax-exempt interest is the MAGI that Medicare reads (the MAGI page details which income items count). Single-earner couples learn this the hard way: a retired 66-year-old with modest personal income can land in a surcharge tier entirely on the strength of the younger spouse's paycheck. The 2026 test is the combined 2024 return against the joint thresholds, beginning above $218,000, regardless of whose name earned the dollars.
How much does IRMAA cost a couple in 2026?
| Joint MAGI (2024 return) | Monthly IRMAA per spouse (Part B + Part D) | Couple total per year |
|---|---|---|
| > $218,000 – ≤ $274,000 | $95.70 | $2,296.80 |
| > $274,000 – ≤ $342,000 | $240.40 | $5,769.60 |
| > $342,000 – ≤ $410,000 | $385.00 | $9,240.00 |
| > $410,000 – < $750,000 | $529.60 | $12,710.40 |
| ≥ $750,000 | $578.00 | $13,872.00 |
Computed from the CMS 2026 tables (announced November 14, 2025): each yearly figure is 2 x (Part B IRMAA + Part D IRMAA) x 12.
Two enrolled spouses, both parts, twelve months: the formula never gets more complicated than that. At the top, a couple with 2024 joint MAGI at or above $750,000 pays $13,872.00 a year in surcharges beyond the two standard premiums they already pay. The complete tables on the 2026 IRMAA brackets page carry per-person monthly detail for every tier, single filers included. Hand the IRMAA calculator a joint MAGI and it returns each spouse's tier along with the doubled couple figure.
Does each spouse get their own bill and their own appeal?
Both, and the paperwork does not merge. SSA issues a determination letter to each spouse individually, each with a separate 60-day window to seek reconsideration. When a life-changing event cuts the couple's income, retirement for instance, the joint MAGI estimate is identical on both requests, yet SSA still wants one filing per beneficiary; a single SSA-44 fixes a single spouse's surcharge. Collection is individual too: the surcharge comes out of each spouse's own Social Security payment, and a spouse not yet drawing benefits gets their own Medicare invoice instead. The IRMAA appeal page maps the correction grounds and the escalation steps.
Does filing separately split the bill?
No. Splitting the return does not split the surcharge, and for spouses who lived with each other at any time in the year it backfires badly: the separate-filer table skips the middle tiers, so any 2024 MAGI above $109,000 goes straight to the fourth-tier rate of $446.30 a month on Part B. The three-row table and the lived-apart exception live in the guide to IRMAA when filing separately.
Couple questions people ask
Do husband and wife both pay IRMAA?
Yes, once each, provided each has Medicare. Two enrollments mean two surcharges from one joint MAGI; one enrollment means one surcharge.
How is IRMAA calculated for married filing jointly?
From the joint return: line 11 plus line 2a gives the couple's MAGI, which is measured against the joint thresholds (starting above $218,000 of 2024 income for 2026). Every enrolled spouse is then charged that tier's amounts.
Per-beneficiary billing is built into CMS's own 2026 premium tables; the separate-determination and life-changing-event rules come from SSA POMS HI 01120.001 and HI 01120.005; the separate-filer tiers come from the same CMS fact sheet.