Social Security Troubleshooting: How To Appeal IRMAA Medicare Charges

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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.

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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.

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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.

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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.

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