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| Subpart A [Reserved] | |
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| Subpart B—Medicare Part B Income-Related Monthly Adjustment Amount | |
| Introduction, General Provisions, and Definitions | |
| Sec. | |
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| What is this subpart about? |
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| Purpose and administration. |
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| Definitions. |
| Determination of the Income-Related Monthly Adjustment Amount | |
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| What is the income-related monthly adjustment amount? |
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| What is the threshold? |
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| What is the effective date of our initial determination about your income-related monthly adjustment amount? |
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| What are the modified adjusted gross income ranges? |
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| How do we determine your income-related monthly adjustment amount? |
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| How will the income-related monthly adjustment amount affect your total Medicare Part B premium? |
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| How will we phase in the income-related monthly adjustment amount? |
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| What modified adjusted gross income information will we use to determine your income-related monthly adjustment amount? |
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| What will happen if the modified adjusted gross income information from IRS is different from the modified adjusted gross income information we used to determine your income-related monthly adjustment amount? |
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| How do we determine your income-related monthly adjustment amount if IRS does not provide information about your modified adjusted gross income? |
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| When will we use your amended tax return filed with IRS? |
| Determinations Using a More Recent Tax Year's Modified Adjusted Gross Income | |
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| When will we determine your income-related monthly adjustment amount based on the modified adjusted gross income information that you provide for a more recent tax year? |
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| What is a major life-changing event? |
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| What is not a major life-changing event? |
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| What is a significant reduction in your income? |
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| What is not a significant reduction in your income? |
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| Which more recent tax year will we use? |
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| What is the effective date of an income-related monthly adjustment amount initial determination that is based on a more recent tax year? |
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| When will we stop using your more recent tax year's modified adjusted gross income to determine your income-related monthly adjustment amount? |
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| Should you notify us if the information you gave us about your modified adjusted gross income for the more recent tax year changes? |
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| What will happen if you notify us that your modified adjusted gross income for the more recent tax year changes? |
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| What evidence will you need to support your request that we use a more recent tax year? |
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| What kind of major life-changing event evidence will you need to support your request for us to use a more recent tax year? |
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| What major life-changing event evidence will we not accept? |
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| What kind of significant modified adjusted gross income reduction evidence will you need to support your request? |
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| What modified adjusted gross income evidence will we not accept? |
| Determinations and the Administrative Review Process | |
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| What is an initial determination regarding your income-related monthly adjustment amount? |
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| What is not an initial determination regarding your income-related monthly adjustment amount? |
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| When may you request that we make a new initial determination? |
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| How will we notify you and what information will we provide about our initial determination? |
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| What is the effect of an initial determination? |
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| When may you request a reconsideration? |
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| Can you request a reconsideration when you believe the IRS information we used is incorrect? |
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| What should you do if our initial determination is based on modified adjusted gross income information you believe to be incorrect? |
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| What are the rules for our administrative review process? |
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| Is reopening of an initial or reconsidered determination made by us ever appropriate? |
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| What are the rules for review of a reconsidered determination or administrative law judge decision? |
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| What are the rules for reopening a decision by an administrative law judge of the Office of Medicare Hearings and Appeals (OMHA) or by the Medicare Appeals Council (MAC)? |
| Subpart C [Reserved] | |
| Subpart D—Medicare Part D Subsidies | |
| Introduction, General Provisions, and Definitions | |
| Sec. | |
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| What is this subpart about? |
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| Purpose and administration of the program. |
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| Definitions. |
| Eligibility for a Medicare Prescription Drug Subsidy | |
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| How do you become eligible for a subsidy? |
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| Who does not need to file an application for a subsidy? |
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| What happens when you apply for a subsidy? |
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| What events will make you ineligible for a subsidy? |
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| What happens if your circumstances change after we determine you are eligible for a subsidy? |
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| When is a change in your subsidy effective? |
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| What are redeterminations? |
| Filing of Application | |
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| Must you file an application to become eligible for a subsidy? |
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| What makes an application a claim for a subsidy? |
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| What is a prescribed application for a subsidy? |
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| Who may file your application for a subsidy? |
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| When is your application considered filed? |
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| How long will your application remain in effect? |
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| When will we use your subsidy inquiry as your filing date? |
| Income | |
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| What is income? |
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| What is not income? |
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| Whose income do we count? |
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| What is earned income? |
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| How do we count your earned income? |
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| What earned income do we not count? |
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| What is unearned income? |
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| What types of unearned income do we count? |
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| How do we count your unearned income? |
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| How do we determine the value of in-kind support and maintenance? |
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| What types of unearned income do we not count? |
| Resources | |
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| What are resources? |
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| What types of resources do we count? |
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| Whose resources do we count? |
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| How do we determine countable resources? |
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| How are funds held in financial institution accounts counted? |
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| What resources do we exclude from counting? |
| Adjustments and Terminations | |
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| What could cause us to increase or reduce your subsidy or terminate your subsidy eligibility? |
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| How would an increase, reduction or termination affect you? |
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| When would an increase, reduction or termination start? |
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| How could you qualify for a subsidy again? |
| Determinations and the Administrative Review Process | |
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| When do you have the right to administrative review? |
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| What is an initial determination? |
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| Is there administrative or judicial review for administrative actions that are not initial determinations? |
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| Will we mail you a notice of the initial determination? |
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| What is the effect of an initial determination? |
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| What is the process for administrative review? |
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| How do you request administrative review? |
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| Can anyone request administrative review on your behalf? |
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| How do we determine if you had good cause for missing the deadline to request administrative review? |
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| Can you request that the decision-maker be disqualified? |
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| How do we make our decision upon review? |
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| How will we notify you of our decision after our review? |
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| Can your request for a hearing or case review be dismissed? |
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| How will you be notified of the dismissal? |
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| How does our decision affect you? |
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| What is the process for correcting Agency clerical errors? |
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| What happens if your case is remanded by a Federal court? |
SOURCE: 70 FR 77675, Dec. 30, 2005, unless otherwise noted.
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Last reviewed or modified Wednesday Sep 17, 2008 |
