Reimbursement of Medicare fees: Who is entitled and how to request it
Some Medicare beneficiaries may be eligible for reimbursement if they have been paying a certain surcharge. Find out who is qualified and how to request it.
For decades, Medicare has offered health insurance programs to adults aged 65 and older, as well as other eligible people in specific medical situations or with some disability.
This insurance has different plans, known as parts A, B, C and D, which cover different needs. Part A relates to in-patient services, Part B covers services administered outside the hospital, Part C (Medicare Advantage) expands coverage of Parts A and B, and Part D offers prescription drug coverage.
The rates for each plan also vary and are determined based on the income of those who are eligible, so beneficiaries with higher incomes have to pay surcharges on their Medicare premiums. However, in some situations you may be eligible for a refund of these fees.
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Reimbursement of Medicare fees: Who is entitled and how to request it
Some beneficiaries must pay an extra amount on top of their Part B or Part D premium if their income is above a certain limit. This extra fee is known as the Income-related Monthly Adjusted Amount or IRMAA.
The Social Security Administration determines who pays IRMAA based on income reported two years prior. In the case of 2023, the SSA analyzes your 2021 tax returns to see if you should pay the IRMAA.
The IRMAA is calculated every year. This means that if your income goes higher or lower, your IRMAA status changes. If the SSA determines that you must pay IRMAA, you will receive a notice with the new premium amount and the reason for that computation.
However, in some cases, Medicare beneficiaries can appeal the amount. According to the SSA, if you have had a “situation that has caused changes in your life and reduced your household income,” you can request to reduce the additional amount you will pay for Medicare Part B and Part D.
These situations include marriage, divorce, death of a spouse, loss of income, or a severance payment from an employer.
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Upon receipt of the IRMAA notice, you have 60 days to file an appeal or request to reduce this monthly adjustment based on your income. To get started, you can contact the SSA at 800-772-1213 (TTY: 800-325-0778). For more information you can also enter the SSA web portal.