Retired (or Soon Will Be)? How to Appeal Higher Medicare Premiums IF YOU (OR YOUR CLIENTS) RECENTLY RETIRED OR SOON will, and you’re enrolled in Medicare (or will be), it’s critical to understand Income-Related Monthly Adjustment Amounts (IRMAAs). These are essentially surcharges added to the Medicare premiums of beneficiaries with incomes above certain levels. At first glance, it may seem reasonable for the federal government to charge higher-income individuals more for health insurance; however, IRMAAs are based on your income from two years earlier, which may differ from your current income. And if you’re subject to one, the additional charge can be hundreds or even thousands of dollars. The good news is the government recognizes that certain events can cause income to decline—and retirement is one of them. So, you can file an appeal. Let’s explore some key questions about this process. WHAT’S AN IRMAA? Federal law requires some Medicare beneficiaries, based on their income, to pay higher premiums. This affects Medicare Part B (medical insurance) and Medicare Part D (prescription drug coverage). It doesn’t apply to Medicare Part A (hospitalization). For 2026 Medicare Part B, the standard monthly premium is $202.90 (up from $185 in 2025). Part D premiums vary by plan and are typically set by Medicare-approved private insurers. IRMAAs are tacked on to the standard monthly premiums. Because they’re based on your modified adjusted gross income (MAGI) as reported on your federal tax return from two years earlier, your 2024 MAGI will determine whether you must pay an IRMAA in 2026. HOW IS LIABILITY TRIGGERED? The income thresholds that trigger IRMAAs are adjusted annually for inflation. For example, in 2026, if your 2024 MAGI was lower than $109,000 (or $218,000 for married couples filing jointly), you generally won’t have to pay the additional amount. For more specifics about this year’s numbers, see the “2026 Medicare Income-Related Monthly Adjustment Amounts (IRMAAs)” chart in this article. So, let’s say you retire in 2026, but you reported a 2024 MAGI of $210,000 while you were still working. In this case, your monthly 2026 Medicare Part B premium would initially be $649.20 (the $202.90 standard amount plus a $446.30 IRMAA). WHEN CAN I FILE AN APPEAL? The IRS provides taxpayers’ MAGI to the U.S. Social Security Administration (SSA), which determines whether Medicare beneficiaries must pay an IRMAA. If the income reported no longer reflects your current situation, you can file an appeal by submitting Form SSA-44, “Medicare Income-Related Adjustment Amount – Life-Changing Event,” to the SSA. Most people do so after receiving an IRMAA determination notice. However, to succeed at an appeal, you must prove that you experienced a “life-changing event,” such as: Divorce, Death of a spouse, Loss of income-producing property, or Work reduction or stoppage (including retirement). When filing the form, you’ll need to provide the date of the event and the amount of your MAGI (actual or anticipated), along with evidence that your income has decreased. Evidence may include a copy of your federal tax return, a severance agreement, or a letter from an employer stating that your employment was reduced or ended. If you’re self-employed, you may need to include certain other information, such as a signed personal statement. WILL MY APPEAL LIKELY SUCCEED? The SSA doesn’t publish statistics on how many requests are approved or denied. Many initial requests are delayed or rejected because of documentation errors. If your appeal is successful, the IRMAA will be reduced or eliminated, lowering your Medicare premiums. In some cases, refunds of excess premiums paid after the life-changing event are issued. Such refunds generally cover all months back to the effective date of the life-changing event. 30 Nebraska CPA
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