IRMAA Reimbursement
Frequently Asked Questions to help you determine if you are eligible for IRMAA reimbursement, how to apply, and more.
Q. What is IRMAA?
A. The Income-Related Monthly Adjustment Amount (IRMAA) is an additional amount that you are required to pay for your monthly Medicare premiums if you have higher annual earnings. If your income in 2021 was less than or equal to $97,000 as an individual, or less than or equal to $194,000 as a married couple, you did not pay IRMAA in 2023 and the following information does not apply to you.
Q. Am I eligible for IRMAA reimbursement?
A. You are eligible for reimbursement as a New York State or Participating Employer retiree if you or your dependent paid IRMAA for Medicare Part B. Please refer to the infographic below to help determine if you paid IRMAA for Medicare Part B in 2023. You may also contact your local Social Security office to verify whether you paid IRMAA by visiting https://www.ssa.gov/onlineservices or calling
800-772-1213. IRMAA reimbursement is not automatic; you must apply for it each year. NYSHIP does not have the legal authority to reimburse the Medicare Part D portion of the IRMAA assessment.
IRMAA – Did you pay in 2023?
| If you received Social Security Benefits | |||
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Look at your 2023 SSA-1099
Sample SSA-1099 Form |
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Look at the amount listed next to the field labeled "Medicare Part B premiums deducted from your benefits" | ||
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Divide that amount by how many months you were enrolled in Medicare Part B. If the amount is greater than $164.90, excluding any penalties, you paid IRMAA. | ||
| If you paid CMS for Medicare Part B | |||
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Gather a monthly CMS-500 or CMS-20143 Sample CMS-500 Bill Sample CMS-20143 Statement |
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Look at the amount listed under the field labeled "Part B IRMAA" | ||
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If the amount is greater than $0.00, you paid IRMAA | ||
Q. What do I need to submit?
A. Submit the Medicare Part B IRMAA Reimbursement Application and proofs of all payments for your or your dependent's Medicare Part B premium. The application is a fillable form, but it must be printed and physically signed. You can send the application and proofs of all payments to our secure fax number at 518-485-5590 or mail to:
NYS Department of Civil Service
Employee Benefits Division
Program Administration Unit
Empire State Plaza, Core Building 1
Albany, NY 12239
Q. What is considered acceptable proof of IRMAA payment?
A. If you receive Social Security benefits, your proof of all payments for last year is the SSA-1099 that Social Security mailed to you in January. SSA-1099 is a tax form that shows the total amount of Social Security benefits you received. If you cannot find your SSA-1099, request a replacement copy from Social Security at https://www.ssa.gov/myaccount/replacement-SSA-1099.html.
If this does not apply to you, refer to the Acceptable Proof of Payment Chart below.
| Acceptable Proof of Payment Chart for IRMAA Documentation is required for each person for whom you are applying. Proof of payment must indicate payments made for all months of each year. |
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| Did you collect Social Security or Railroad Retirement benefits? | Enclose Proof of Payment of Medicare Part B premium: | Where can you obtain this proof? |
| Yes |
Form SSA-1099 or RRB-1099 Retirement Benefit Statement or RL-800D Railroad Retirement Notice |
Social Security Administration or Railroad Retirement Board |
| No |
CMS-500 Medicare Premium Bill (Submit bill for each period paid) or CMS-20143 Medicare Easy Pay Premium Statement (Submit bill for each period paid) |
Centers for Medicare and Medicaid Services (CMS) | Partial Year |
SSA-1099 and CMS-500 or CMS-20143 or RRB-1099 and CMS-500 or CMS-20143 |
(See above) |
| Contact Information | ||
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Social Security Administration (SSA) www.ssa.gov/onlineservices 1-800-772-1213 |
Centers for Medicare and Medicaid Services (CMS) www.cms.gov 1-800-633-4227 |
Railroad Retirement Board (RRB)
www.rrb.gov/Benefits/Medicare 1-877-772-5772 |
Q. Did you receive my application?
A. You can call the Employee Benefits Division at 518-457-5754 or 1-800-833-4344 and press 4, then 2 to listen to a recorded message with the current processing status of IRMAA applications. Due to the high volume of requests, you can expect the process to be completed within 90 to 120 days from receipt and acceptance of all required documents. Applications are processed in the order in which they are received. The deadline for applications is three years after the tax filing deadline for that year.
Q. How will I receive reimbursement?
A. If you are determined eligible for IRMAA reimbursement, you will receive a reimbursement check from the Office of the State Comptroller. You will receive a letter documenting the details of your reimbursement. You will also receive written notification if EBD determines you are ineligible for IRMAA reimbursement.
Q. Can IRMAA be reimbursed for a deceased enrollee?
A. Yes, you can apply for IRMAA on behalf of a deceased enrollee. The person listed as the Executor/Executrix for the deceased enrollee may apply for reimbursement on their behalf. You will need to submit a copy of the Executor/Executrix paperwork along with the signed application and proof of payment documentation.