How to appeal Medicare premium IRMAA surcharges

For 2022, IRMAAs will go into effect for individuals with a modified adjusted gross income greater than $91,000. For married couples filing joint tax returns, surcharges start at over $182,000. With higher income limits, the surcharges increase. (See diagrams below.)

The surcharge for Part B ranges from $68 to $408.20 this year, depending on income. Based on this year’s standard monthly premium of $170.10, this results in IRMAA-affected beneficiaries paying premiums of between $238.10 and $578.30.

For Part D, 2022 surcharges range from $12.40 to $77.90. This is in addition to any premiums you pay, whether through a standalone prescription drug plan or through a Medicare Advantage plan, which typically includes Part D. These rewards may vary between plans.

The Centers for Medicare & Medicaid Services has not yet announced 2023 amounts for various costs related to the program, including income thresholds for IRMAAs or the exact amount of the supplement associated with each tier.

This year, 5.3 million Medicare beneficiaries paid Part B IRMAAs and an estimated 6.8 million will do so in 2023, according to the latest Medicare Trustees report. For Part D, 4.5 million beneficiaries are subject to IRMAAs this year, and an estimated 5.8 million will pay the surcharge in 2023.

If you think your new income would mean that you don’t pay a surcharge or at least pay less, it’s worth filing an appeal. However, requesting the change isn’t generally something you can do before your Medicare coverage begins or before the Social Security Administration sends you a “benefit assessment letter.”

“Often we see that right after enrolling in Part B, beneficiaries receive an invoice for the standard premium, and weeks later they receive a second invoice with the addition of the IRMAA,” said Danielle Roberts, co-founder of insurance company Boomer Benefits.

“Because the Social Security Administration does not make this initial decision in time for the IRMAA to even make its way into the first premium bill, you don’t want to attempt to request a reconsideration of a decision that has yet to be made,” Roberts said.

In order to prove that your current income is lower, you must ask the Social Security Administration to reconsider their assessment. You will need to fill out a form and provide supporting documents.

Suitable evidence can e.g. E.g. a recent tax return (if available), a pension statement from your former employer, recent payslips or similar showing that your income has fallen.

The required form contains a list of “life-changing” events that qualify as reasons for IRMAAs being reduced or removed, including marriage, death of a spouse, divorce, loss of pension, or the fact that you have stopped working or your to reduce working hours.