Social Security Troubleshooting: How To Appeal IRMAA Medicare Charges

Close up of a senior couple dealing with their home finances.
vorDa / Getty Images

For the majority of Medicare beneficiaries, the government will pay about 75% of the Part B premium, and the beneficiary will pay the remaining 25%. The standard Part B premium is $148.50 ($170.10 in 2022) per month — or higher depending on your income. Some people with higher incomes will be required to pay a higher monthly Part B premium.

See: Here’s How Much Waiting To Enroll in Medicare Part B Can Cost You
Find: Claiming Social Security, SNAP and Medicare Is Now Easier Thanks to Executive Order — What’s Changing?

These adjustments come in the form of income-related monthly adjustments, or IRMAAs, which are adjusted monthly based on how high your income is. Individual filers with a yearly income of $88,000 or more and couples filing jointly with a yearly income of $178,000 or more are charged this adjustment.

However, there are a few life-changing events, as well as tax filing errors, that could have you paying more than you should.

If you feel you are overpaying your Medicare premium, there’s a way you can request a new initial determination or appeal the current one.

Life-changing events typically include marriage, divorce, spousal death, work stoppage, work reduction, loss of income-producing property, loss of pension income or employer settlement payment. You will need to provide documentation proving any of the attestations you make regarding your income change, be it through marriage or divorce certificates, tax returns, or letters from employers depending on your circumstance.

Retire Comfortably

For income discrepancies, Medicare uses the modified adjusted gross income reported on your IRS tax return from 2 years ago to determine this. This is the most recent tax return information provided to Social Security by the IRS. If you have proof the income level is incorrect, or you amended the tax return and the new income isn’t reflected, you can appeal the income adjustment.

The first step is to fill out the SSA-44, “iMedicare Income-Related Monthly Adjustment Amount – Life-Changing Event” form and wait for a decision.

See: Retirement: Medicare Part B Will Rise 14.5% Next Year — More Than Double the Estimate
Find:
When Social Security Runs Out: What the Program Will Look Like in 2035

If your appeal isn’t approved, you can continue to fight the IRMAA by requesting a hearing before an Office of Medicare Hearings and Appeals (OMHA) Administrative Law Judge.

If you’re still not satisfied, there are several more levels of appeals you can go through including the Medicare Appeals Council and finally, Federal District Court. Each appeal needs to be made within 60 days of receiving the results from the previous action. It’s important to note you can only appeal to the district court if your claim is $1,300 or more.

Retire Comfortably

More From GOBankingRates

About the Author

Georgina Tzanetos is a former financial advisor who studied post-industrial capitalist structures at New York University. She has eight years of experience with concentrations in asset management, portfolio management, private client banking, and investment research. Georgina has written for Investopedia and WallStreetMojo. 

Untitled design (1)
Close popup The GBR Closer icon

Sending you timely financial stories that you can bank on.

Sign up for our daily newsletter for the latest financial news and trending topics.

Loading...
Please enter an email.
Please enter a valid email address.
There was an unknown error. Please try again later.

For our full Privacy Policy, click here.