Can I Appeal More Expensive Medicare Premiums?

Can I Appeal More Expensive Medicare Premiums?  The standard monthly premium for Medicare Part B is $144.60 in 2020, but some beneficiaries pay as much as $491.60. If your income varies from what the Social Security used to calculate whether you’re subject to those surcharges, there is a way to request the agency to reconsider.

CNBC’s recent article entitled “Here’s how to appeal higher Medicare premiums” explains that the annual income of older Americans could decrease substantially from one year to the next for many reasons, such as retirement, the death of a spouse, or the sale of your business. However, it can take Medicare — which charges higher earners more for premiums — several years to adjust when your income drops below the threshold.

If you’re paying more than the standard premiums for Medicare Part B (outpatient services) and Part D (prescription drugs) through income-related monthly adjustment amounts, or IRMAAs, the difference can mean hundreds of dollars per month. The surcharge is also frequently derived from your tax return from two years before, which may not accurately reflect your current financial situation. When this happens, seniors must contact Social Security and prove that they’re not earning that amount any longer.

For individuals, IRMAAs are triggered if your modified adjusted gross income is greater than $87,000, and for married couples filing joint tax returns, IRMAAs begin above $174,000.

The process to show that your current income is lower, requires you to ask the agency to reconsider its assessment. You also have to complete a form and attach supporting documents. Everyone’s situation is different, but in many cases, suitable proof may include a more recent tax return, a letter from your former employer stating that you retired, more recent pay stubs or something similar showing that your income has dropped.

The form includes a list of “life-changing” events that qualify as reasons for reducing or eliminating the IRMAAs. These include marriage, the death of a spouse, divorce, the loss of pension, or that you stopped working or reduced your hours. If you satisfy one of the qualifying reasons, it usually gets adjusted. If it doesn’t, you can appeal the decision to an administrative law judge. However, that process can be time consuming and you must keep paying the surcharges in the meantime.

The SSA reevaluates your situation every year. This means the IRMAAs (or whether you pay them) could change annually, based upon the volatility of your income.

You should also be aware that the SSA’s decision could leave you financially vulnerable, if your long-term health unexpectedly changes or a one-time health event requires prescription drugs. You also could be hit with late-enrollment penalties, if you don’t qualify for an exception. The same is true for enrolling late in Part B. This should help explain if you can  Appeal More Expensive Medicare Premiums?

Reference: CNBC (February 25, 2020) “Here’s how to appeal higher Medicare premiums”

Read more about this at :         Medicare perscription drug coverage appeals/medicare.gov

                                                               Medicare part B Premium Appeals/HHS.gov

You can also read one of our previous Blogs at :  The High Cost of Medicare Mistakes