Medicare Part B Premiums: What You Can Do If You Think Your Medicare Part B Income-Related Premium Is Incorrect

Medicare Part B provides coverage for physician services, outpatient hospital services, certain home health services, durable medical equipment and other items. Most beneficiaries will pay a standard premium for Part B coverage. Some beneficiaries also will pay a late enrollment surcharge. A small number of beneficiaries with higher incomes will pay a higher Part B premium based on their income.

What if I disagree with the decision about an income-related premium amount?

If you are a Medicare beneficiary who must pay more for your Part B premium because of your income and you disagree with the decision that you need to pay a higher premium amount, you have the right to request an appeal (also known as a reconsideration). You may request an appeal in writing by completing a Request for Reconsideration (Form SSA-561-U2). If you do not have access to the Internet you can request a copy of the form by calling us at 1-800-772-1213 (TTY 1-800-325-0778).

However, if your income has gone down due to certain specific circumstances or you filed an amended tax return, you can ask for a new decision without having to file an appeal. Read our fact sheet, Medicare Part B Premiums: New Rules for Beneficiaries With Higher Incomes (SSA Publication No. 05-10161) for more details. You do not have to file an appeal to get a new initial decision.

What if I disagree with the reconsideration decision?

If you disagree with the reconsideration decision, you can ask for a hearing before an Administrative Law Judge (ALJ) in the Department of Health and Human Services’ (HHS) Office of Medicare Hearings and Appeals. You can request a hearing by completing a Request for Hearing by Administrative Law Judge (Form HA-501-U5). You will also need to complete a Tax Information Authorization (IRS Form 8821) to permit Social Security to disclose your tax information to the ALJ.

If you do not have access to the Internet, you can request copies of Form HA-501-U5 and IRS Form 8821 with information on how to complete it by calling us at 1-800-772-1213 (TTY 1-800-325-0778).

If you disagree with the hearing decision, you can request a review by the HHS Medicare Appeals Council. Further appeals would require a Federal court action.