Have you received a notice that you are being charged a high income surcharge for Part B or Part D?

You might be able to appeal high income surcharges if you have experienced a life changing event.

If you are considered higher income by Medicare and received notice that you are being charged a high income surcharge for either Part B or Part D, you might be able to appeal these extra charges if you have experienced a life changing event.

Medicare bases these surcharges on your income level 2 years ago. If you have retired since then or experienced a different life-changing event you likely have experienced a drop in income and can appeal to have these surcharges removed.

You can download this form, complete it and submit to the Social Security office. Refer to page five of the form to see the list of life-changing events to see if you qualify.

Once you have completed the form, look up your local social security office fax number here and send it via fax - or drop it off at your local social security office. 

A few things to be aware of:

  1. Your reduction in income does not have to be due to the life changing event. For example, let’s say you made 60,000 in the year you retired but also did an IRA Roth conversion for 200,000. Your total income was 260,000 and you would be charged a surcharge. However, because you retired that year you had a life changing event and can appeal the charge and it will get removed. However - if you had retired the year earlier and didn’t have a life changing event you would not be able to appeal and your surcharge would be in effect.
  2. Every January your surcharge will be recalculated and adjusted up or down (or removed) based upon your income tax return from 2 years ago. You do not need to request them to recalculate in January as it happens automatically. Simply wait for the notice of surcharge change.
  3. You can not appeal for multiple years at once, and you cannot be proactive and appeal the surcharge until you receive notice that you will be charged an extra amount. 

 If you need help with this form or have questions, please contact us.