How to Appeal Your Part B Premium
As a medicare beneficiary, most individuals pay a base amount for their Medicare Part B premium, however, if you are one that SSA has identified as having a higher income, especially prior to retirement, you have the right to appeal if you believe that an Income Related Monthly Adjustment Amount (IRMAA) is incorrect for one of the qualifying reasons. (You can find out what your estimated Part B Premium is on this nifty schedule.)
First, you must request a reconsideration of the initial determination from the Social Security Administration. A request for reconsideration can be done orally by calling the SSA 1-800 number (800.772.1213) as well as by writing to SSA using the form SSA-44.
Below are the situations which may qualify a beneficiary for a new Part B determination:
|Tax return inaccurate or out of date||
|Life-changing event that affects the beneficiary’s modified adjusted gross income||There are 7 qualifying life-changing events:
Events that result in the loss of dividend income or affect a beneficiary’s expenses, but do not affect the beneficiary’s modified adjusted gross income are not considered qualifying life-changing events.
Components of Your Part B PremiumBeneath the following equation is specific information on each component of your premium. Equation to Determine Your Part B Premium Medicare Part B Standard Monthly Premium* + Your Income-Based Adjustment** = Your Total Monthly Part B Premium *Set by the Centers for Medicaid and Medicare Services (CMS). **Income Related Monthly Adjustment Amount (IRMAA)
|Part B Premium Component Description||Annual Part B Rate|
|Set by the Centers for Medicaid and Medicare Services (CMS)||The Part B insurance premium is set annually by the CMS. Effective January 1, 2007, Part B beneficiaries with incomes above a certain threshold amount (about 4% to 5% of all Part B beneficiaries) are subject to an adjustment of the amount of the premium that they must pay for Part B insurance.|
|Your Income-Based Adjustment||The Social Security Administration determines your Income Related Monthly Adjustment Amount (IRMAA). The IRMAA is based on information from the individual’s income tax return obtained from the Internal Revenue Service (IRS) and calculated according to a mathematical formula established by law. The IRMAA is then added to the standard premium amount to calculate the beneficiary’s total monthly Part B insurance premium.|