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Ask Ms. Medicare

Marital Status and Medicare Eligibility

How Medicare works when you're in a same-sex marriage

Paying higher-income Part B and Part D premiums

If you live somewhere that recognizes your same-sex marriage, be aware that your Part B and Part D premiums will be assessed on the joint income of you and your spouse and not just you alone.

To be liable for surcharges, the modified adjusted gross income (MAGI) declared on your latest tax return must be at least $85,000 if you're single or married but filing separately; or $170,000 if you're a married couple filing jointly. These dollar thresholds are the same for both Part B and Part D, but the surcharges you actually pay are different for each program and vary according to your income.

Most people with Medicare don't pay these higher premiums — which actually represent a means test designed to reduce the amount of government subsidies for wealthier people. But a relatively high salary from your own and/or your spouse's work, or a sudden income boost (for example, from the sale of a house) could easily put you into a higher-income category.

For more information, see the Social Security Administration document "Medicare Premiums: Rules for Higher-Income Beneficiaries (pdf)."

Applying for programs that lower Medicare costs

Several programs can reduce the costs of Medicare beneficiaries whose incomes and savings are under a certain level. These include:

  • Extra Help — a federal program that provides lower-cost Part D prescription drug coverage

  • Medicare Savings Programs — state-run programs under which the state pays Part B premiums and maybe other expenses (deductibles, copays and Part A premiums) according to income

  • Medicaid — the state-run safety net for health care that pays virtually all the medical costs of people who qualify

If you live in a state that recognizes the validity of same-sex marriages, your eligibility for these programs is based on the joint income and savings of you and your spouse — even if you're the only one applying for assistance — just as it is for any married couple. Usually the income limits for a married couple are significantly lower than those for two single people.

Patricia Barry writes the AARP Ask Ms. Medicare column and is the author of Medicare for Dummies (Wiley/AARP, October 2013).

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