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a beneficiary does not agree with how we figured their IRMAA (addition of the adjusted
gross income (AGI) and tax-exempt interest)
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consider if the beneficiary is asking for reconsideration. To process a reconsideration
request, see HI 01140.005.
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It is important to know what the beneficiary is asking, so that there is no misinformation
or misdirection that could disadvantage the beneficiary.
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the beneficiary claims a life-changing event with a significant reduction in income
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the beneficiary is asking for a new initial determination, not an appeal.
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Process the life-changing event using the appropriate IRMAA input screens.
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Inform the beneficiary that evidence of the reduction in income and the event (unless
already in our records, like a verified death of the spouse) will need to be provided.
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Document the evidence using the Shared Process.
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The beneficiary has a qualifying life-changing event with a reduction in income, a
new initial determination is appropriate. The new decision will have appeal rights.
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the beneficiary disagrees with the information IRS provided us and they have not filed
an amended return or received a correction from IRS
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Determine if the allegation may be an obvious tax-exempt income (TEI) transcription
error.
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If this allegation is not a TEI transcription error, advise the beneficiary to contact
IRS at 1-800-829-1040.
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Advise the beneficiary if IRS agrees that the information is erroneous and documentation
from IRS confirming an IRS error is available, a request for a new initial determination
can be filed.
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If IRS verifies that the information provided to us is an error on IRS’ part, IRS
can correct the information and provide the beneficiary with a correction of the MAGI
information upon the beneficiary’s request.
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the beneficiary has an amended tax return for the tax year we used to determine IRMAA
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the beneficiary is asking for a new initial determination, not an appeal.
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Process the tax information change using the appropriate IRMAA input screens.
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Advise the beneficiary that we need to see the amended tax return and an acknowledgement
letter from IRS. See HI 01120.045.
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Document the evidence using the Shared Process.
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If the beneficiary has more accurate tax information than what we used to determine
IRMAA, a new initial determination is appropriate. The new decision will have appeal
rights.
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the beneficiary claims there was an error in the information IRS supplied us and has
documentation from IRS showing the correction
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the beneficiary is asking for a new initial determination, not an appeal.
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Process the tax information change using the appropriate IRMAA input screens.
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Advise the beneficiary that we need to see the IRS documentation. For guidance on
how to process a new initial determination based on corrected IRS information, see
HI 01120.050.
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Document the evidence using the Shared Process.
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The beneficiary may be eligible for a new initial determination.
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the beneficiary claims that we are using three-year old tax information and has a
copy of the filed two-year old tax return
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the beneficiary is asking for a new initial determination, not an appeal.
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Advise the beneficiary that we need to see the signed PY-2 filed tax return. For guidance
on how to process a new initial determination using beneficiary provided two-year
old tax information, see HI 01120.055.
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Review all evidence submitted.
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Process the tax information change using the appropriate IRMAA input screens.
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Document the evidence using the Shared Process.
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The beneficiary may be eligible for a new initial determination.
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the beneficiary’s tax filing status was Married, Filing Separately, but the beneficiary
did not live with a spouse at any time during the year used to set IRMAA
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the beneficiary is asking for a new initial determination, not an appeal. For information
concerning attesting to living apart throughout the tax year used to set IRMAA, see
HI 01120.060.
If the couple has subsequently divorced, the divorce may be a second life-changing
event; if it resulted in a significant reduction in MAGI.
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If the beneficiary had a tax filing status of Married, Filing Separately, but did
not live with a spouse at any time during the tax year used to set IRMAA, we can make
a new initial determination by applying the tables for a tax filer with a filing status
of Single.
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the beneficiary wants to update an MAGI estimate they gave us for a new initial determination
or to provide or update other information regarding a pending request
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See processing instructions for revising an MAGI estimate in HI 01120.065.
For instruction on updating information regarding a pending request, see HI 01120.001G.
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The updated information may be necessary to process a request to completion or may
affect the current decision in place.
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