Married couples filing separately face high Medicare surcharges
Married couples who file their taxes separately are subject to significant Medicare surcharges. The surcharges start at $109,000 and can reach $446 per month for Part B.
The surcharge schedule for married couples filing separately is steeper than for single or joint filers. Dual filers over $109,000 pay $649 monthly for Part B each, while a joint-filing couple at the same combined income pays no IRMAA.
The standard Part B premium is set at $202.90 per month for 2026. Only about 8% of Part B enrollees pay any IRMAA at all, with the highest surcharges affecting couples who separated their returns for specific reasons.