New Medicare filers and attainers will be charged the standard Part B premium or the
prescription drug plan premium without an IRMAA until we receive MAGI data from IRS.
If IRS returns data indicating that a new filer’s or attainer’s MAGI is above the
appropriate threshold, SSA will send a pre-determination notice. This notice will
explain:
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What information was used to compute IRMAA,
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What the beneficiary can do if the tax information provided by IRS is wrong,
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What the beneficiary can do if SSA used PY-3 information and the beneficiary has a
copy of their filed PY-2 tax return,
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What the beneficiary can do if the tax filing status of “Married, Filing Separately”
for the tax year was used and lived apart from their spouse for the entire year, and
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What the beneficiary can do if there was an LCE with a reduction in income.
This notice does not contain appeal rights but will invite beneficiaries to contact
SSA within 10 days if the beneficiary believes the information is incorrect before
SSA applies IRMAA (e.g., SSA used PY-3 data and the beneficiary has a copy of the
Federal income tax return filed for PY-2). After 20 days (5 days mailing time, 10 days
for the beneficiary to contact SSA and 5 more days of mailing time), SSA sends an
initial determination notice with appeal rights (For information about determination
notices, see HI 01101.035D.).