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appeal Medicare premiums if your income has decreased

Occasionally, new retirees enrolling in Medicare may find themselves paying additional monthly premium charges. However, for those whose income falls on retirement, this may change.

Approximately 7% of the 63.3 million Medicare recipients with income above a set threshold pay “monthly income-related adjustment amounts” or IRMAAs, in addition to the standard Part B premiums (care ambulatory) and part D (prescription drugs). However, the surcharge is based on your most recent tax return available (often two years in advance), which may not accurately reflect your retirement income.

And while you may appeal to IRMAAs, this is generally not something you can do before your Medicare coverage begins or before the Social Security Administration sends you a “benefit determination letter.” .

“We often see beneficiaries receive a standard premium bill right after they enroll in Part B, and then receive a second bill weeks later with the addition of the IRMAA,” said Danielle Roberts, co-founder of the company. Boomer Benefits Insurance.

“Since the Social Security Administration is not making this initial determination in time for the IRMAA not even to begin on the first bill of the premium, you do not want to be trying to ask for a reconsideration of a decision that is still pending. ‘It has to be taken,’ ‘Roberts said.

By 2022, IRMAAs are starting for people with modified adjusted gross income of more than $ 91,000. For married couples filing joint tax returns, surcharges start above $ 182,000. Additional charges increase at higher income thresholds.

The standard Part B monthly premium this year is $ 170.10, which is what most Medicare beneficiaries pay. (Part A, which provides hospital coverage, usually does not include any premiums.)

The surcharge for the highest income ranges from $ 68 to $ 408.20, depending on income. This translates into monthly premiums ranging from $ 238.10 to $ 578.30.

For Part D, surcharges for 2022 range from $ 12.40 to $ 77.90. This is in addition to any premiums you pay, either through a self-prescription drug plan or through a Medicare Advantage Plan, which typically includes Part D. Although premiums vary for prescription coverage, the average for by 2022 it is about $ 33.

The process for proving that your current income is lower is to ask the Social Security Administration to reconsider your assessment. You must complete an SSA-44 form and provide supporting documents.

Proper proof may include a more recent tax return (if available), a letter from your former employer stating that you have retired, more recent pay stubs, or something similar that shows your income. they have fallen.

The required form includes a list of “life-changing” events that are considered reasons to reduce or eliminate IRMAAs, such as marriage, the death of a spouse, divorce, loss of pension, or the fact that you left to work or reduce your hours.

Assuming your reconsideration request works, you will be credited with any IRMAA you paid for.

“Fortunately they will do it retroactively and it will be applied as credit to your bill,” Roberts said.

If your efforts fail, you can appeal the decision to an administrative law judge, although the process may take some time, and in the meantime you will continue to pay these surcharges.

In addition, your situation is reassessed each year, which means that IRMAAs (or if you pay them) may change annually, depending on the volatility of your income.

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