Because an IRMAA is based on income reported on tax returns from 2 years prior, some Medicare beneficiaries will receive notice their monthly premiums for Medicare Part B and Part D are increasing. In other words, they receive an IRMAA (Income-Related Monthly Adjustment Amount). If this happens, beneficiaries may need to know how to file an IRMAA appeal.
In the event the beneficiary has a significant change in their financial circumstances, they might be eligible to file an appeal to reduce or eliminate the adjustment.
What’s an IRMAA
IRMAA is an additional charge the Social Security Administration adds to Medicare Part B and Part D premiums when an individual has a higher than average income. The SSA uses the beneficiary’s MAGI from 2 years prior to determine the adjustment amount. For example, the 2025 premiums are decided by the MAGI from a 2023 tax return.
Learn about Part B IRMAAs
Find out about Part D IRMAAs – click here
Reasons to file an IRMAA appeal
Those who experience a life-changing event that caused a decrease in income, or feel the IRMAA is incorrect, can request a reconsideration. A few qualifying life-changing events include:
- Retiring or reduction in work hours
- Loss of a spouse due to divorce or death
- Elimination of a pension plan
- Loss of income producing property due to disaster or other circumstance
Click here to watch a YouTube video on Part B IRMAAs
How to File an IRMAA Appeal
1. Read and understand the notice
The initial determination letter from the SSA explains the IRMAA and includes instructions for appeal. It is important to understand if the IRMAA is based on outdated or incorrect information.
2. Gather supporting documents
Get any documents together that prove a difference in your current financial situation compared with two years prior. Examples of this may include:
- Employer letter that confirms retirement or reduced work hours
- Divorce, marriage or death certificates
- Tax returns that show lower income
- Insurance claims or documentation of property loss
3. Complete the SSA-44 form
When a beneficiary receives an IRMAA, they should receive instructions to file an appeal including the SSA-44 form. For those who need a SSA-44 form, click here to download and fill it out. The form will request details about life-changing events, current income, and expected income for the year.
4. How to submit the appeal
Once the form is complete, add supporting documentation and either mail it to the address included in the determination letter or on the SSA-44 form or drop it off to a local SSA office. Be sure to follow up on the appeal and provide any additional information SSA requests. Those who file an appeal receive a written decision.
If the appeal is denied
Those who have their appeal denied can request a hearing before an administrative law judge. A request for a hearing must be filed within 60 days of denial receipt. For more complex cases, it may be a good idea to seek professional assistance from an attorney, financial advisor or Medicare expert.
Some ways to ensure a successful IRMAA appeal include; filing the appeal as soon as possible to avoid overpaying premiums. It is also important to make sure all documents are accurate and through and know when expert advice is necessary.
Leave a Comment