Appealing improper Medicare premium payments

in /Ask Phil by

James – Maryland: I have been retired for nearly three years and enrolled in Social Security and Medicare when I turned 65. With Medicare, I opted in to Parts A and B. I did not get a Part D drug plan because I was able to stay on the prescription drug plan offered through my former employer. Upon receiving my first benefit statement from Social Security, I noticed a deduction for prescription drugs that representing a high-income surcharge. Together with what I am paying through my former employer program, my monthly cost for prescription drugs has nearly doubled!

I understand the rationale for high-income Medicare surcharges and am more than willing to pay my fair share. What I don’t understand is why I am making such payments for something I don’t have and from which I am deriving no benefit? I also can’t understand why no one informed me of these surcharges in the first place. Could you help me understand all this?

Phil Moeller: If you have credible drug coverage from an employer retiree plan, your former employer should be able to provide you a statement to that effect. Credibility means that the retiree plan is comparable to a typical Medicare Part D plan.

Armed with this statement — which employers are legally required to provide you upon request — you should appeal to Social Security to stop deducting Part D payments. In a truly fair world, you’d be able to get refunds of past payments, and I certainly would request this. However, I wouldn’t hold my breath.

Here is Social Security’s general appeals page. There also is a separate page for appeals of Medicare’s high-income surcharges. I have never seen an online form that allows people to challenge Part D payment withdrawals or Part D IRMAA charges. Given that your withdrawal results in you receiving a smaller Social Security benefit than you deserve, perhaps you can use this as the basis for an appeal.

As for the lack of notice about surcharges, this is just one more area where Medicare and Social Security fail miserably in transparency and outreach communications.

Trying to get Social Security to do the right thing can be time-consuming and exhausting, but I urge you not to give up and to please let me know how things turn out.