2508.Overview of the Appeal Process for Medicare Income-Related Monthly Adjustment Amount

Once an Income-Related Monthly Adjustment Amount (IRMAA) determination is made for Medicare Part B or D or both , SSA mails a notice to the beneficiary. The notice informs the beneficiary of the determination and appeal rights. The notice also provides information about what a beneficiary should do if they have other information about their income or if their circumstances have changed. The IRMAA determination will apply to both Medicare Part B and D where applicable. If an appeal is filed, the appeal determination will also apply to both Part B and D if applicable.

2508.1When can an appeal be filed?

A beneficiary or his authorized representative can request an appeal within 60 days of receipt of an IRMAA determination notice.

2508.2What are the levels of appeal?

There are four levels of appeal that apply to IRMAA determinations:

  • A reconsideration processed by the Field Office or Processing Center

  • A hearing before an Administrative Law Judge of the Department of Health and Human Services (HHS) Office of Medicare Hearings and Appeals

  • A review by the HHS Medicare Appeals Council, and

  • Federal Court action.

Last Revised: Aug. 10, 2011