Life Changing Events
Qualifying Life-Changing Events
If you’ve seen your Medicare premiums increase due to the Income-Related Monthly Adjustment Amount (IRMAA), you might be wondering if you can appeal it.
You can, but only under specific circumstances. An IRMAA appeal is based on the idea that your financial situation has changed dramatically, making the tax data from two years ago an inaccurate reflection of your current ability to pay.
To successfully appeal your IRMAA, you must demonstrate two key things:
1. You experienced a qualifying life-changing event.
2. This event caused your income to drop significantly, placing you in a lower IRMAA bracket.
The Social Security Administration (SSA) uses your modified adjusted gross income (MAGI) from two years prior to set your premiums. For example, your 2025 premiums are based on your 2023 tax return. The appeal process exists for individuals whose recent life events make that older income data obsolete. Simply earning less money isn’t enough to qualify; the drop in income must be linked directly to one of the specific events recognized by the SSA.
What is a Life Changing Event
The SSA has a defined list of events that can trigger a reassessment of your IRMAA. If your income has been reduced because of one of the following, you may be eligible for a successful appeal.
Marriage:
Getting married can change your tax filing status and household income.
Divorce or Annulment:
The end of a marriage often results in a significant change in income for one or both individuals.
Death of a Spouse:
Losing a spouse can drastically reduce household income.
Work Stoppage:
This is a common reason for appeals and refers to a complete stop in your work, such as retiring.
Work Reduction:
This applies if you or your spouse have reduced your work hours, leading to a significant drop in earned income.
Loss of Income-Producing Property:
This event applies when property is lost due to a disaster or other event beyond your control and is not a result of a sale or transfer.
Loss of Pension Income:
This covers situations where a pension plan is terminated or fails.
Employer Settlement Payment:
This applies if you or your spouse received a settlement payment from an employer due to the employer’s closure, bankruptcy,
or reorganization.
Conclusion
Understanding your options for appealing Medicare IRMAA premiums can result in significant savings on your healthcare costs. If you’ve experienced one of the qualifying life-changing events outlined above and your income has decreased substantially, you may be eligible to have your premiums recalculated based on your current financial situation rather than outdated tax data.
The key to a successful IRMAA appeal lies in demonstrating both the occurrence of a qualifying event and the resulting income reduction that places you in a lower IRMAA bracket. While the process may seem complex, many beneficiaries who meet the criteria find that appealing their IRMAA determination leads to meaningful premium reductions.
Remember that timing is important with IRMAA appeals, and having proper documentation of both your qualifying event and income change will strengthen your case. If you believe you qualify for an IRMAA appeal, consider consulting with a professional who understands the intricacies of the process to maximize your chances of success.
If one of these events applies to you and has lowered your income, you can schedule a Free Initial Consultation to speak with a Certified IRMAA Advisor who can professionally appeal IRMAA for you.
All of our Certified IRMAA Advisors used to work for the Social Security Administration before joining our team so we have decades of experience successfully appealing IRMAA for our clients.
