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What is the New Initial Determination Process?
A new initial determination is a new decision made by SSA that does not require reopening or revising a prior initial determination during a specified period. New initial determinations are only used in the Income-Related Monthly Adjustment Amount (IRMAA) process.
In order for SSA to make a new initial determination of IRMAA:
the beneficiary must have a qualifying circumstance, and
the beneficiary must request, either verbally or in writing, that SSA use other tax information.
2506.1 When can a beneficiary request a new initial determination?
There are five qualifying circumstances when SSA may use modified adjusted gross income (MAGI) provided by the beneficiary rather than the information received from IRS to make a new initial determination about the income-related monthly adjustment amount.
The five circumstances are:
Amended Tax Return
Correction of IRS information
Use of two-year old tax return when SSA used IRS information from three years prior to the premium year
Report of a change in living arrangement when tax filing status is "Married filing separately"
Life-changing event(s) from the list in §2507.
Last Revised: May 22, 2007
- What are Life Changing Events?
- Overview of the Appeal Process for Medicare Part B Income-Related Monthly Adjustment Amount
- Description of the Medicare Part B Income-Related Monthly Adjustment Amount Determination Process
- What is Modified Adjusted Gross Income (MAGI)?
- How Does the Income-Related Monthly Adjustment Amount Affect the Total Medicare Part B Premium?
- How to Read and Understand the Initial Determination
- What is a farm?
- Domestic Service Defined
- Initial Determinations
- Administrative Actions that are not Initial Determinations
- Initial determinations
- Reopening Final Determinations or Decisions Under the Rules of Administrative Finality
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