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Why am I paying more for Medicare than others?

Why am I paying more for Medicare than others?

March 07, 2023

An IRMAA, or Income Related Medicare Adjusted Amount, is an additional payment that Medicare beneficiaries could be subject to pay depending on their income level. The thresholds for IRMAA fees change each year. Additional IRMAA premiums apply to Medicare part B and Part D. The internal Revenue Service, IRS, determines if a Medicare recipient will have an IRMAA applied to their Medicare premium. They do this by analyzing Medicare recipients’ income from two tax years prior to the current Medicare premium year. For example, an IRMAA premium for the year 2023 will be determined from the Medicare recipients 2021 tax return.

How do I know if I will have an IRMAA?

The Social Security administration will reach out to the Medicare recipient by mail notifying them that they will have an IRMAA applied to their Medicare premium. A Medicare recipient can anticipate their IRMAA amount for an upcoming year. To do this they must first identify their modified adjusted gross income, or MAGI. Social Security provides a table on their website, the same table that is below, which can be used to determine what IRMAA premiums will be. The following table is for the 2023 year.


Is there any way to change my IRMAA determination?

An IRMAA determination can potentially be changed due to several life changing events. The life changing event must significantly reduce the Medicare recipients income or change their filing status to be approved. Examples of life changing events are, Marriage, Divorce or Annulment, the Death of a spouse, Work stoppage or reduction, Loss of an income-producing property, Loss of pension income, or an employer settlement payment. If a Medicare recipient experiences a life changing event, they can fill out a form SSA- 44 found on the Social Security website and send it to their local office. 

How do I complete the SSA-44 form?

On page one write your name and social security number.  Then you will complete the five main parts:

Step 1: Choose the life changing event that affects you.

Step 2: Complete the Reduction of Income section. 

  1. If you retire in March for example, write your total income for that tax year in the box.

Step 3: Modified Adjusted Gross Income

  1. Speak with your Advisor at Harford Financial Group and they can help you complete this section. If you want to complete this section on your own you must add up your income including Social Security, Pension, Rental income and IRA Withdrawals, as well as any part time income you may be receiving.

Step 4: Documentation

  1. If you fax this form, make sure you include the documentation as well. Write your Social Security number at the top of each additional page just in case it is separated at the Social Security Office.

Step 5: Sign the document and include your Phone number and address.

You can find your local office by visiting this website and enter your zip code.

When can I file for a new initial determination?

A Medicare recipient can file for a new initial determination as soon as a life changing event occurs.  The Applicants gross income for sections two and three on the SSA-44 form can be estimated if official information is not yet available. The social security administration will reach out to the applicant for official statements when they become available. Refunds may be available for excess IRMAA fees that occur following a life changing event. For a refund to be consider the new initial determination must be received no later than March 31st of the year following the life changing event.


What else do I need to know about filing a new initial determination?

There are a few additional procedures that applicants should be aware of when submitting a new initial determination. If the applicant is married filing jointly, both spouses should submit a new initial determination. If the application is denied, the applicant is entitled to submit an appeal up to 60 days following when they received the denial by mail. If you want to physically deliver this form and documents to your local Social Security Office we recommend visiting right when they open on a Tuesday, Wednesday or Thursday as these times tend to be less busy.