What Is IRMAA?
IRMAA is an additional charge applied to your Part B and/or Part D premium if your income exceeds a certain threshold. The Social Security Administration (SSA) determines whether you owe IRMAA based on your IRS tax return from two years prior. For example, your 2026 IRMAA would be based on your 2024 tax return.
If you have questions about why you are paying IRMAA, contact the Social Security hotline at 800-772-1213.
Note: If you also have a Part B or Part D late enrollment penalty, your premiums may be higher.
Can IRMAA Be Appealed?
If you’ve been notified that you owe an Income-Related Monthly Adjustment Amount (IRMAA) on top of your Medicare Part B or Part D premium, you may be wondering if you can appeal. The good news is, yes, IRMAA can be appealed under certain circumstances. Below, we’ll walk you through the process of understanding IRMAA, requesting a review, and appealing a decision.
What Is IRMAA?
IRMAA is an additional charge applied to your Part B and/or Part D premium if your income exceeds a certain threshold. The Social Security Administration (SSA) determines whether you owe IRMAA based on your IRS tax return from two years prior. For example, your 2026 IRMAA would be based on your 2024 tax return.
If you have questions about why you are paying IRMAA, contact the Social Security hotline at 800-772-1213.
Note: If you also have a Part B or Part D late enrollment penalty, your premiums may be higher.
Requesting a New Initial Determination
If you receive an initial determination notice from SSA stating you owe IRMAA, you can request a new initial determination if:
You experienced a life-changing event that decreased your income.
Life-changing events recognized by SSA include:- Death of a spouse
- Marriage
- Divorce or annulment
- You or your spouse reduced or stopped working
- Involuntary loss of income-producing property due to a natural disaster, disease, fraud, or other circumstances
- Loss of a pension
- Settlement payment from an employer due to closure or bankruptcy
The income information used by SSA is outdated or incorrect.
For example, you can request a review if:- You filed an amended tax return.
- You have a more recent tax return showing lower income than the one SSA used to calculate your IRMAA.
To request a new determination, submit a Medicare IRMAA Life-Changing Event form or schedule an appointment with SSA. Be sure to provide documentation to support your case, such as updated tax returns or proof of the life-changing event.
Appealing an IRMAA Decision
If you don’t qualify for a new initial determination or disagree with SSA’s decision, you can appeal the IRMAA decision. This process, called a reconsideration, involves SSA reviewing their initial determination.
Steps to Appeal an IRMAA Decision:
File a request for reconsideration.
Contact SSA for instructions on filing. If your reconsideration is successful, your premiums will be adjusted.Appeal to the Office of Medicare Hearings and Appeals (OMHA) if reconsideration is denied.
- Submit your appeal within 60 days of the denial.
- Provide new evidence within 10 days of filing, or request an extension if needed.
- If successful, your premium amount will be corrected.
Appeal to the Council if OMHA denies your case.
- File the appeal within 60 days of the OMHA denial.
- A successful appeal will adjust your premium accordingly.
Appeal to the Federal District Court if the Council denies your case.
- File the appeal within 60 days of the Council denial.
Key Takeaways
- You can request a new initial determination or appeal an IRMAA decision.
- Life-changing events or incorrect income information are valid reasons to request a review.
- The appeals process has multiple levels, allowing you to escalate if your request is denied.
If you believe your IRMAA is incorrect, don’t hesitate to take action. Contact SSA, gather your documentation, and start the appeal process today. By understanding your rights and the available steps, you can ensure your Medicare costs are accurate.
For more personalized guidance, call the Social Security hotline at 800-772-1213 or visit your local SSA office.