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Medicare Part B Premiums: What You Can Do If You Think Your Medicare Part B Income-Related Premium Is IncorrectSSA Publication No. 05-10125, August 2008, ICN 444820 (En Español) (View .pdf) |
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.
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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.
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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.
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Contacting Social Security For more information, visit our website at www.socialsecurity.gov/mediinfo.htm
or call toll-free, To learn more about Medicare Part B coverage,
visit www.medicare.gov
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Last reviewed or modified Monday Aug 11, 2008 |