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Frequently Asked Questions About IRMAA and Medicare

Medicare can definitely be a complicated subject. Team SJB is here to help make sense of it.

If you have questions about any aspect of Medicare, depend on Team SJB to understand your unique needs and prescribe a solution. We will spend time getting to know your personal needs and finding the right policy for you. We have partnerships with all the major insurance providers, so we can manage the lowest cost policy or a policy that provides extra benefits or security to suit your needs. 

What is IRMAA?

IRMAA is the acronym for Income Related Monthly Adjustment Amount. The Social Security Act requires some people to pay higher premiums for Medicare Part B (Medical Insurance) and Medicare Part D (Prescription Insurance) based on their modified adjusted gross income. Since 2007, higher-income Medicare enrollees have been required to pay the IRMAA surcharge for Part B coverage. An IRMAA surcharge for Part D premiums took effect in 2011.

What income is counted towards IRMAA?

The IRMAA surcharge is determined by income reported on your tax returns from two years prior. This means that your 2020 income tax return is used to determine your 2022 Medicare premiums. The income used to determine IRMAA is a form of Modified Adjusted Gross Income (MAGI), but it’s specific to Medicare. This amount is recalculated annually.  Depending on your income, an IRMAA can be added, increased, decreased or removed each year. You will receive notice from the Social Security Administration (SSA) to inform you if you are being assessed IRMAA. A beneficiary will be notified by SSA near the end of the current year if he or she has to pay an IRMAA for the upcoming year. If you are unsure why you are paying an IRMAA, you can call the Social Security hotline at 800-772-1213.

How is IRMAA paid?

If you are already drawing Social Security and the amount of your check can cover your IRMAA charges, then the SSA will automatically deduct the IRMAA from your Social Security check. If you are not yet drawing Social Security, or the IRMAA charges exceed the amount of your check, then you will receive a bill for the unpaid IRMAA balance.

Can you appeal an IRMAA calculation?

You can ask the Social Security Administration to reconsider your income-related monthly adjustment amount or IRMAA. The amount could be adjusted due to a life changing event such as marriage, divorce, or death of a spouse, loss of a job, loss of income producing property due to a natural disaster, or loss of a pension. You will have to supply supporting documentation for the appeal. You can also make the case that Social Security used outdated or incorrect information when calculating your IRMAA if you have filed an amended tax return with the IRS or you believe the SSA used older or out-of-date tax data to determine your IRMAA. There is no guarantee that Social Security will reverse your higher-premium determination, but it is certainly worth a try if one of these situations applies. An appeal will not cost you anything and it could end up saving you money.

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