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Overview of the Appeal Process for Medicare Part B Income-Related Monthly Adjustment Amount

2508. Overview of the Appeal Process for Medicare Part B Income-Related Monthly Adjustment Amount

Once an Income-Related Monthly Adjustment Amount (IRMAA) determination has been made, a notice is mailed to the beneficiary. The notice will inform the beneficiary of the determination and appeal rights. The notice will also provide information about what a beneficiary should do if they have other information about their income or if their circumstances have changed.

2508.1 When can an appeal be filed?

A beneficiary or his authorized representative can request an appeal within 60 days of receipt of an IRMAA determination notice.

2508.2 What are the levels of appeal?

There are four levels of appeal that apply to IRMAA determinations:

  • A reconsideration processed by the Field Office

  • A hearing before an Administrative Law Judge of the Department of Health and Human Services (HHS) Office of Medicare Hearings and Appeals

  • A review by the HHS Medicare Appeals Council, and

  • Federal Court action.

Last Revised: May 22, 2007


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Comments

Medicare Part B premium

December 30, 2008 by Guest

page 21 of the 2009 medicare & You book states, most people will pay the standard premium amount. However, your monthly premium will be higher if you meet the following conditions:
* You are single (file an individual tax return), and your yearly modified adjusted gross income is more than $82,000 (in 2008).
*You are married (file an joint tax return) and your yearly modified adjusted gross income is more than $164,000 (in 2008).
In both of the above examples the book refers to income in 2008 however the letters being sent to higher income people shows the income-related monthly adjustment amount based on your 2007 income tax return.

correct form to use to appeal income related part B premium.

December 30, 2008 by Guest

The letter advising people of their increased part B premium mentions appealing by using form SSA-561-U2 and online sources advise using form SSA-44. SSA-561-U2 appears to be unrelated and only to be used for SSI/SVP use.

Appealing Medicare part B income-related premium

January 26, 2009 by Guest

It is almost impossible to appeal even if your income drops drastically. Whether you deal with the administration or the local office, neither of them is very familar with the situation. In fact most of them never heard of form ssa-44 and do not know much about the whole procedure and are not even concerned because according to them it only involves about 5% of the population. One of the most disgusting issues is the fact that most everyone receiving social security was sent the 2009 book medicare & You which clearly states on page 21 that your monthly premium will be higher if you meet the following conditions:
. You are single (file an individual tax return), and your yearly modified adjusted gross income is more than $82,000 (in 2008)
.You are married (file a joint tax return), and your yearly modified adjusted gross income is more than $164,000 (in 2008). However the letters received by the people that were assessed the income related adjustment showed 85,000 & 170,000 and most importantly were based on their 2007 tax return. Supposedly you can ask to have another year considered but it has to be what in their opinion is a life threatening event.

Change to enrollment in Part B

October 19, 2009 by Guest

I recently enrolled in Part A & B medicare, effective Dec 09. Since I am still working and my employer health benefits cover the part B, I want to delay my enrollment til I retire. I have been calling the Neptune office but am unable to get through. How can get my coverage changed to Part A only? I cannot find the form on line. Rosemary D

Dropping Medicare Part B

October 19, 2009 by David Luhman

If you are working and covered by your employer group health insurance, your Part B benefits may be of limited value to you as long as your group health insurance is the primary payer of your medical bills.

If you have Medicare Part B and decide to drop it while you are working and covered by your employer group health insurance, you can sign up for Medicare Part B again during your Special Enrollment Period. As long as you enroll in Part B during your Special Enrollment Period, you will not have to pay a higher Part B premium.

Note: If you are working for a small company (less than 20 employees), you should talk to your employee health benefits administrator before making any decision not to take Medicare Part B.

See http://questions.medicare.gov/cgi-bin/medicare.cfg/php/enduser/std_adp.p...

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