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What is the New Initial Determination Process?

Excerpted from "Social Security Handbook". See the up-to-date, official Social Security Handbook at

2506. What is the New Initial Determination Process?

A new initial determination is a new decision made by SSA that does not require reopening or revising a prior initial determination during a specified period. New initial determinations are only used in the Income-Related Monthly Adjustment Amount (IRMAA) process.

In order for SSA to make a new initial determination of IRMAA:

  • the beneficiary must have a qualifying circumstance, and

  • the beneficiary must request, either verbally or in writing, that SSA use other tax information.

2506.1 When can a beneficiary request a new initial determination?

There are five qualifying circumstances when SSA may use modified adjusted gross income (MAGI) provided by the beneficiary rather than the information received from IRS to make a new initial determination about the income-related monthly adjustment amount.

The five circumstances are:

  • Amended Tax Return

  • Correction of IRS information

  • Use of two-year old tax return when SSA used IRS information from three years prior to the premium year

  • Report of a change in living arrangement when tax filing status is "Married filing separately"

  • Life-changing event(s) from the list in §2507.

Last Revised: May 22, 2007

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There are 2 Comments

I was billed for IRMAA based on income tax information from 2 years prior to the effective time it was assessed., I filed form SSA 44 to get a redetermination based on current tax information for 2011, the year during which I paid the IRMAA. SS decision letter redetermined the IRMAA and decision said effective 2011 I didn't owe an IRMAA. (I had already paid each month for the entire year). How do I get that amount reimbursed to me? I have tried everything to no avail. Medicare owes me a substantial amount of money and I can get no one to tell me the procedure for a reimbursement.

The SSA states that if you got a letter from Social Security that showed you would be getting a refund of the income-related monthly adjustment amount for your Medicare premiums, you should have received your refund within 30 days of receipt of your letter.

If 30 days have passed from the date of your notice, please call the SSA at 1-800-772-1213.

You can find the SSA's Program Operations Manual System (POMS) regarding IRMAA here :!openview&restrictt...

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