Some circumstances allow us to use the modified adjusted gross income (MAGI) information
the beneficiary provides, rather than the information we receive from IRS to make
a new initial determination of the IRMAA. See the circumstances listed in HI 01120.001D in this section.
If the beneficiary meets the criteria for a new initial determination, there is no
need to appeal the prior determination. For an overview of the appeals process for
IRMAA, see HI 01140.001.
In order for us to make a new initial determination of IRMAA, the beneficiary:
must have a qualifying circumstance; and
must request, either verbally or in writing, that we use other tax information.
NOTE: A beneficiary can file an appeal and request a new initial determination at the same
time, if filed within the appeals period.
A request for a new initial determination applies only to the beneficiary requesting
If a beneficiary requests a new initial determination and provides information that
could affect a spouse or ex-spouse, we do not extend its findings to the non-reporting
spouse or ex-spouse. It is the responsibility of the affected beneficiary to contact
If a beneficiary has a representative payee, the beneficiary or the payee can request
a new initial determination on the beneficiary's behalf.