There will be cases when a beneficiary or the spouse of a beneficiary experiences
one or more of the life changing events (LCE) listed in HI 01120.005C in this section, causing a significant reduction in modified adjusted gross income
(MAGI). A “significant” reduction in MAGI is a reduction that decreases or eliminates
the income-related monthly adjustment amount (IRMAA) for a specific tax year. A beneficiary
who has experienced an LCE causing a significant reduction in MAGI may request us
to make a new initial determination using a more recent tax year, than the tax year
used previously to impose IRMAA.
When a beneficiary states the LCE caused the significant reduction in income, process
the request for a new initial determination based on the beneficiary's statement.
As part of processing the request for a new initial determination, the beneficiary
must attest under penalty of perjury that all statements made are true and correct.
If the beneficiary attests under penalty of perjury that the LCE caused the significant
reduction in income, we accept that statement. We do not develop the types of income
that make up the MAGI, just that the MAGI decreased and that the LCE occurred prior
to the decrease in MAGI, regardless of how far in the past the LCE occurred.
NOTE: A report of an LCE with a significant reduction in MAGI applies only to the beneficiary
reporting. If a beneficiary reports an LCE with a significant reduction in MAGI that
could affect a spouse or ex-spouse, we do not extend its findings to the nonreporting
spouse. If the LCE affects the nonreporting spouse, it is his or her responsibility
to contact us.
If the beneficiary has not filed a tax return for the current premium year, the beneficiary
must provide us with an estimate for the more recent tax year. The beneficiary also
has the option to give a second tax year estimate for the next premium year if the
LCE also affects it. If he or she gives an estimate for the current premium year,
but not for the next premium year, use the current year estimate for the next premium
EXAMPLE: If a beneficiary provides an estimate for tax year 2007 for premium year 2007, he
or she can also provide an estimate for premium year 2008. If he or she gives no estimate
for premium year 2008, you must input the 2007 tax year estimate for 2008. You must
make two separate premium year inputs for all LCE's (with the exception of non-qualifying
life-changing events (NQE)).
NOTE: Beneficiaries may use the optional Form SSA-44 (Medicare Income-Related Monthly Adjustment
Amount – Life-Changing Event) to report a life-changing event with a significant reduction
in income. If you receive an SSA-44 without a second tax year estimate, contact the
beneficiary to request a second year estimate. Inform the beneficiary that if there
is no second year estimate, we use the first year estimate for the next year as well.