Understanding IRMAA: A Medicare Customer Question

The SSA reevaluates whether or not to apply IRMAAs to Medicare premiums every year.

Depending on your client’s income in a given year, an IRMAA may be added, removed, or updated.

If an IRMAA is correctly applied to your client’s premium, the amount will simply be added to your client’s monthly bill.

If your client receives an IRMAA notice from the SSA and feels that the notice was sent in error, your client may file an appeal within 60 days of the notice.

Outside of this time frame, the SSA will determine if there are legitimate grounds for an appeal.

Your client may appeal if your client suspects that the SSA used inaccurate or outdated financial information to determine the IRMAA.

Your client can also appeal if your client has experienced significant qualifying events that would impact your client’s income, including marriage/divorce, death of a spouse, or reduction/cessation of work.

If appealing due to a qualifying event, various forms of documentation will likely be required for submission.

Client who are uncertain about their financial situation and how it may impact their premiums should be talking to you, and their tax planners, about that.

Understanding how IRMAAs are calculated and applied, as well as what Medicare looks at and considers as income, will allow your clients to maximize their Medicare benefits.

Bethany Cissell is a health care insurance services specialist at Allsup.

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