Medicare Part B Premiums: What You Can Do If You Think Your Medicare Part B Income-Related Premium Is Incorrect

Medicare Part B provides coverage for physician services, outpatient hospital services, certain home health services, durable medical equipment and other items. Most beneficiaries will pay a standard premium for Part B coverage. Some beneficiaries also will pay a late enrollment surcharge. A small number of beneficiaries with higher incomes will pay a higher Part B premium based on their income.

What if I disagree with the decision about an income-related premium amount?

If you are a Medicare beneficiary who must pay more for your Part B premium because of your income and you disagree with the decision that you need to pay a higher premium amount, you have the right to request an appeal (also known as a reconsideration). You may request an appeal in writing by completing a Request for Reconsideration (Form SSA-561-U2). If you do not have access to the Internet you can request a copy of the form by calling us at 1-800-772-1213 (TTY 1-800-325-0778).

However, if your income has gone down due to certain specific circumstances or you filed an amended tax return, you can ask for a new decision without having to file an appeal. See our fact sheet, Medicare Part B Premiums: New Rules for Beneficiaries With Higher Incomes (SSA Publication No. 05-10161) for more details. You do not have to file an appeal to get a new initial decision.

What if I disagree with the decision on my reconsideration?

If you disagree with the reconsideration decision, you can ask for a hearing before an Administrative Law Judge (ALJ) in the Department of Health and Human Services’ (HHS) Office of Medicare Hearings and Appeals. You can request a hearing by completing a Request for Hearing by Administrative Law Judge (Form HA-501-U5). You also will need to complete an Authorization for SSA to Disclose Tax Information for Your Appeal of Your Medicare Part B Income-Related Monthly Adjustment Premium Amount (Form SSA-54) for Social Security to disclose your tax information to the ALJ.

If you do not have access to the Internet, you can request copies of Form HA-501-U5 and Form SSA-54 by calling us at 1-800-772-1213 (TTY 1-800-325-0778).

If you disagree with the hearing decision, you can request a review by the HHS Medicare Appeals Council. Further appeals would require a Federal court action.