Income Related Monthly Adjustment Amounts (IRMAA)

The IRMAA is calculated anew each year so if your income changes, your IRMAA will be adjusted. It is based on your last filed tax return. Your initial determination takes into account the last two filed returns. 

The Social Security Administration will notify you by mail of the IRMAA. If you have received this notification and you feel it is incorrect, or if you feel there are extenuating circumstances that could affect the IRMAA, you can request a new initial determination based on a life-changing event. Life changing events include death of a spouse, marriage, divorce or annulment, work stoppage or reducing the number of hours you work, involuntary loss of income-producing property due to a natural disaster, disease, fraud or other circumstances, loss of pension, receipt of settlement payment from a current or former employer due to the employer’s closure or bankruptcy.

You can submit a Medicare IRMAA Life-Changing Event form (available online) or schedule an appointment with SSA to request a new determination. If you do not qualify to request a new determination under a Life-Changing Event, or if you disagree with the determination, there is a four-level appeal process.

The first level of appeal is called Reconsideration. You can contact the Social Security Administration to learn how to file this request. If your reconsideration is successful, your Medicare Part B and D premiums will be adjusted. If it is unsuccessful, you can choose to appeal to the Office of Medicare Hearings and Appeals. Note that there are specific time frames in which you must submit the appeal at this stage and above, however there is the opportunity to request extensions if you are unable to provide the pertinent information within the time frame allowed. The next level of appeal is the Council level, and the fourth level is the Federal District Court. This is the final level of the Medicare appeals process.

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