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How to appeal on high premiums


Due to the law changing over the years and requiring higher earners to pay more, about 4.3 Million Medicare beneficiaries are subject to so-called income-related monthly adjustment. While the standard monthly premium for Medicare Part B is $144.60 this year, some beneficiaries pay as much as $491.60. If your income is different from what Social Security used to determine, there is a process for asking the agency a reconsideration. 

Note: If you are unsure why you are paying an IRMAA, you can call Social Security, 800-772-1213.

The process involves asking the agency either through a phone call or through writing to reconsider their assessment.


You will have to fill out a form and provide supporting documents such as:


  • a recent tax returns
  • a letter from your former employer stating that you have retired
  • recent pay stubs showing evidence that your income has dropped. 



The required form includes a list of life-changing events that qualify as reasons for reducing or eliminating the IRMAAs:

  • marriage
  • death of a spouse
  • divorce
  • loss of pensions
  • you've stopped working or reduced your hours

You can also make the case that Social Security used outdated or incorrect information when calculating your IRMAA, if example, you;
  • Filed an amended tax return with the IRS
  • Have a more recent tax return that shows you are receiving a lower income than previously reported
As long as you meet one of the listed qualifying reasons and submitted the remaining pertinent documents, most likely you will get an adjustment. If it doesn't and you still won't agree with the decision, you can still file an appeal to reconsider.

Keep in mind that there are no strict timeframes in which Social Security must respond to a reconsideration request. 

  • You can appeal to the Office of Medicare Hearings and Appeals (OMHA) level within 60 days of the date on the reconsideration denial. You can contact legal services organization or a lawyer to help you with this or any further levels of appeal, but this is not required. You must submit new evidence within 10 days of filing your OMHA level appeal. (Contact OMHA for further instructions). If you cannot comply right, you can still ask for an extension.
  •  If your OMHA appeal again gets denied, you can still file on your Council level. If your Council level is successful, your Part B premium amount will automatically get adjusted. 
  • If the Council denies, you can choose to appeal to the Federal District Court within 60 days of the date of the Council denial.


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