If you do not qualify to request a new initial determination, but you still disagree with Social Security’s IRMAA decision, you have the right to appeal. Appealing an IRMAA decision is also referred to as requesting a reconsideration. Keep in mind that there are no strict timeframes in which Social Security must respond to a reconsideration request. If you have questions about your appeal status, contact the agency reviewing your appeal.
- Complete a request to SSA for reconsideration. Contact SSA to learn how to file this request.
- If your reconsideration is successful, your premium amounts will be corrected. If your reconsideration is denied, you can appeal to the Office of Medicare Hearings and Appeals (OMHA) within 60 days of the date on the reconsideration denial. Follow the directions on the denial to file an appeal at the OMHA level. If you decide to appeal at the OMHA level, you may wish to contact a legal services organization or lawyer to help you with this or any further levels of appeal, but this is not required.
- You must submit any new evidence within 10 days of filing your OMHA level appeal. Contact OMHA for further instructions on submitting. You can ask OMHA for an extension if you are unable to submit new evidence within 10 days.
- If your OMHA level appeal is successful, your premium amount will be corrected. If your appeal is denied, you can choose to appeal to the Council within 60 days of the date on the OMHA level denial.
- If your Council appeal is successful, your premium amount will be corrected. If the Council denies your appeal, you can choose to appeal to the Federal District Court within 60 days of the date on the Council denial.
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