How to Appeal the Part B Premium

By Brian Krantz - February 28, 2023

part b premium

In this article, we will provide you with valuable information on how to appeal the Part B premium if you believe that the Income Related Monthly Adjustment Amount (IRMAA) is incorrect for one of the qualifying reasons. The Social Security Administration (SSA) determines the Part B premium for Medicare beneficiaries based on their income. If you experience a life-changing event that affects your income, you may qualify for a new Part B determination, and your premium may be adjusted accordingly. However, if you believe that the IRMAA is incorrect, you have the right to appeal the determination.

Step 1: Request a Reconsideration

The first step in appealing the Part B premium is to request a reconsideration of the initial determination from the Social Security Administration. You can do this by calling the SSA 1-800 number (800.772.1213) and requesting an oral reconsideration. Additionally, you can submit a Life-Changing Event Form SSA-44 to the SSA for your convenience. This form is designed to collect information about your life-changing event, which may qualify you for a new Part B determination. Here is a link to the form: https://www.ssa.gov/forms/ssa-44.pdf

Step 2: Qualifying Reasons for a New Part B Determination

There are several situations that may qualify a beneficiary for a new Part B determination. If you experience any of the following life-changing events, you may be eligible to have your Part B premium adjusted:

  • Inaccurate or Out-of-Date Tax Return: If your tax return was inaccurate or out of date and you filed an amended tax return for the year being used to make an IRMAA decision, this may qualify you for a new Part B determination.
  • Error in IRS Data: If there was an error in the IRS data, you may be eligible for a new Part B determination.
  • Updated Information: If the IRS provided SSA with older data and you want to use newer information, this may qualify you for a new Part B determination.
  • Significant Income Reduction: If you had a major life-changing event that significantly reduced your income, this may qualify you for a new Part B determination.
  • Life-Changing Event Affecting Modified Adjusted Gross Income: If you experience a life-changing event that affects your modified adjusted gross income, you may be eligible for a new Part B determination.

There are seven qualifying life-changing events:

  1. Death of a spouse
  2. Marriage
  3. Divorce or Annulment
  4. Work Reduction
  5. Work Stoppage
  6. Loss of Income from Income-Producing Property
  7. Loss or Reduction of Certain Kinds of Pension Income

Step 3: Be Patient and Persistent

It is important to note that the appeals process can take several months, so it is essential to be patient and persistent in your efforts. The SSA may require additional documentation to support your appeal, so it is crucial to provide them with any necessary documentation promptly.

Frequently Asked Questions

Q: Can I appeal the Part B premium if my income has changed due to the COVID-19 pandemic?

A: Yes, if your income has changed due to the COVID-19 pandemic, you may be eligible for a new Part B determination. You can request a reconsideration of the initial determination from the SSA and provide them with any necessary documentation to support your appeal.

Q: How long does the appeals process take?

A: The appeals process can take several months, depending on the complexity of your case and the workload of the SSA. It is important to be patient and persistent in your efforts to appeal.

Q: What documentation do I need to provide to support my appeal?

A: The SSA may require documentation to support your appeal, such as tax returns, W-2 forms, or other proof of income. Be sure to provide them with any

 

If you have any further questions about how to appeal the Part B Premium, reach out to the New York Medicare advisors at Plan Medicare and we can help answer any of your questions.

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