Dolli Gratiana

Medicare Irmaa 2024 Appeal Form. Fill out a “request form for retrospective appeal of medicare part a coverage” and mail or fax it to the address on the form. Did you receive an irmaa determination letter?

If you disagree with medicare’s decision in determining your premiums, you have the ability to have a right to appeal by filing a “request for reconsideration” using form ssa. If you want to appeal your irmaa, you should visit the social security website and complete the request for reconsideration form.