Ask Rusty: About Tax Filing Status and Medicare

Dear Rusty: I’m trying to figure out if I should change my IRS filing status to “Married – Filing Jointly” prior to getting reviewed for my Medicare Part B and Part D. My current IRS status is “Married – Filing Single” and I noticed this filing status is more stringent. I will be turning age 62 soon and I have read that Medicare will review my income two years prior to turning 65. Any input would be appreciated. Signed: Uncertain Senior Dear Uncertain: Your IRS tax filing status has no bearing on your eligibility for Medicare Part B (coverage for outpatient health-care services) or Medicare Part D (insurance coverage for prescription drugs). Medicare is an individual health care program, so enrolling in Medicare provides coverage for you (only), not your spouse (your spouse’s Medicare eligibility will be individually evaluated). What your IRS filing status may affect is the amount of your Medicare Part B and Part D premiums. There is a Medicare provision called IRMAA (income-related monthly adjustment amount), which sets the income thresholds on which your Medicare premiums are based, and those thresholds are different if you file your income tax as a single, or as “married/filing jointly.” The IRMAA thresholds can change annually, and there is no way to yet determine what they will be when you are able to enroll in Medicare at age 65 (they are currently $106,000 if you file as a single, and $212,000 if you file your taxes as “married/jointly”). If your “provisional income” (your combined income from all sources) exceeds the threshold for your filing status, you will pay higher (than standard) Medicare Part B and Part D premiums. If your income is lower than the threshold, you will pay only whatever the standard Medicare Part B premium is for the year you start Medicare, and there will be no supplemental premium for your Part D coverage. For information, the IRMAA supplements are progressive — that is, the more you exceed the threshold by, the higher your IRMAA premium supplement will be. To see the current IRMAA thresholds and supplements (again, these will likely change when you are eligible for Medicare), visit: www.cms.gov/newsroom/fact-sheets/2025-medicare-parts-b-premiums-and-deductibles. You are correct that your Medicare premium, when you enroll, will be determined by your total income from two years prior. So, if you plan to enroll in Medicare at age 65 (sometime in 2028), it is your 2026 income which will determine your Part B and Part D premiums, and that income will be defined by your 2026 income-tax return. Note, too, that Medicare premiums are reevaluated each year, based upon your IRS income-tax return from two years prior. FYI, there are advantages to filing your income tax as “married/jointly” (compared to married/filing separately), and those are best evaluated by your tax advisor (we are not tax advisors here at the AMAC Foundation). And while it’s true that the IRMAA thresholds are higher when you file as “married/jointly,” it’s also true that your total income as a married couple will be used when determining your IRMAA premiums for Medicare. So, once again, it is probably best to consult with a qualified income-tax advisor for guidance on whether it is best, financially, for you to change how you file your income tax in 2026, considering that you will be enrolling in Medicare in 2028. One final thing: If you are still working and have “creditable” health-care coverage from your employer (“creditable” is a group plan with at least 20 participants), then you can delay enrolling in Medicare until your employer coverage ends (thus temporarily avoiding the Medicare premiums). In other words, if you have creditable health-care coverage from an employer, you don’t have to enroll in Medicare immediately at age 65.

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Russell Gloor is a national Social Security advisor at the AMAC Foundation, the nonprofit arm of the Association of Mature American Citizens (AMAC). The 2.4-million-member AMAC says it is a senior advocacy organization. Send your questions to: ssadvisor@amacfoundation.org. Author’s note: This article is intended for information purposes only and does not represent legal or financial guidance. It presents the opinions and interpretations of the AMAC Foundation’s staff, trained, and accredited by the National Social Security Association (NSSA). The NSSA and the AMAC Foundation and its staff are not affiliated with or endorsed by the Social Security Administration (SSA) or any other governmental entity.