Medicare; How to Appeal an IRMAA

To begin with, let us describe what an IRMAA is. It is a surcharge placed on your monthly premium for Medicare Parts B and D. This surcharge is based on your income taxes filed two years ago. So, in 2020, your IRMAA is based on your income tax filed in 2018.

IRMAA stands for Income Related Modified Adjusted Amount. A government way of saying a surcharge or a fine for earning too much money according to Medicare. It is really a tax on those that have done well for themselves and family. The surcharge is based in income levels and your marital status. Those that are single or widowed pay based on their income while married people pay on a different and higher scale of income. It is conceivable if your income is high you could be paying two or three times the monthly amounts for Part B. There is a separate charge for Part D. The current monthly premium for Medicare Part B is $144.90. That amount will change annually so the surcharges keep going up. The numbers are set each year in December for IRMAA’s starting in January and run for the entire calendar year.

The appeal process is really very simple. Obtain the form from the local social security office, on-line on or ask your Medicare broker for the form. The form # is SSA-44. The form is easy to complete and once done file with social security for their review. It is better to go to the social security office and meet with a social security rep and get your answer before you leave the office. In this difficult time you have to mail or fax the request in and wait for a response as the local social security offices are closed.

Usually the reason for the appeal is a one-time increase in income or a spike in income for one year and then your income goes down to previous years. This one-time spike in income can be for selling your home; earning additional money from investments or a large commission earned during the year. The appeal form asks why you are seeking this appeal and the proof is on you. I have seen many people over the years have the appeal approved. In one case the individual sold several houses during the year and his income spiked to over $500,000. His income the following year was below the levels needed to have the IRMAA applied. He appealed and got the surcharge removed. I have seen others do the same thing for different reasons and get the appeal approved. I have not seen many appeals refused and that is a good thing for all of us.

The income levels are based on your modified adjusted gross income, not your gross income. Those that are self-employed, or CPA’s understand that, and you should seek help to write the appeal if needed.

I personally hope everyone has to pay an IRMMA meaning you are financially well off. So, file the appeal and see if it is approved.


Len Barend, broker

The Barend Agency Inc.


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