Medicare IRMAA appeal form
If you have a client who receives a IRMAA, they can use the Medicare IRMAA appeal form to try and lower their Medicare Part B adjustment amount. In certain circumstances, your client can file an appeal and have their IRMAA reduced due to a reduction in their income. There are many different circumstances that can effect a beneficiary’s income. They could be recently divorced, widowed or lost a source of income some other way.
If your client falls under any unfortunate circumstance that lowers there income you can help by downloading the following form:
Click here for Medicare IRMAA appeal form.
They can also file an appeal by setting up an in-person meeting with their local Social Security office. They can do this by calling 1-800-772-1213.
Please see the chart below for the 2019 IRMAA amounts:
| This is the adjusted Part B amount for 2019, if the yearly income in 2017 was: | You pay each month (in 2019) | ||
|---|---|---|---|
| Individual tax return | File joint tax return | File married & separate tax return | |
| $85,000 or less | $170,000 or less | $85,000 or less | $135.50 |
| $85,000 up to $107,000 | $170,000 up to $214,000 | Not applicable | $189.60 |
| $107,000 up to $133,500 | $214,000 up to $267,000 | Is not applicable | $270.90 |
| $133,500 up to $160,000 | $267,000 up to $320,000 | Not applicable | $352.20 |
| $160,000 and less than $500,000 | $320,000 and less than $750,000 | $85,000 and less than $415,000 | $433.40 |
| $500,000 or above | $750,000 and above | $415,000 and above | $460.50 |
If you would like to become a member of our team, please contact us either by phone at (203)796-5403 or by email at teal@croweandassociates.com. We are here to help answer your Medicare and other health insurance coverage questions.
If you have a client with low income level, click here for information on special programs available to help them.
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