20 CFR Part 418 — Medicare Subsidies
Subpart B — Medicare Part B Income-Related Monthly Adjustment Amount
- § 418.1001— What is this subpart about?
- § 418.1005— Purpose and administration.
- § 418.1010— Definitions.
- § 418.1101— What is the income-related monthly adjustment amount?
- § 418.1105— What is the threshold?
- § 418.1110— What is the effective date of our initial determination about your income-related monthly adjustment amount?
- § 418.1115— What are the modified adjusted gross income ranges?
- § 418.1120— How do we determine your income-related monthly adjustment amount?
- § 418.1125— How will the income-related monthly adjustment amount affect your total Medicare Part B premium?
- § 418.1135— What modified adjusted gross income information will we use to determine your income-related monthly adjustment amount?
- § 418.1140— What will happen if the modified adjusted gross income information from IRS is different from the modified adjusted gross income information we used to determine your income-related monthly adjustment amount?
- § 418.1145— How do we determine your income-related monthly adjustment amount if IRS does not provide information about your modified adjusted gross income?
- § 418.1150— When will we use your amended tax return filed with IRS?
- § 418.1201— When will we determine your income-related monthly adjustment amount based on the modified adjusted gross income information that you provide for a more recent tax year?
- § 418.1205— What is a major life-changing event?
- § 418.1210— What is not a major life-changing event?
- § 418.1215— What is a significant reduction in your income?
- § 418.1220— What is not a significant reduction in your income?
- § 418.1225— Which more recent tax year will we use?
- § 418.1230— What is the effective date of an income-related monthly adjustment amount initial determination that is based on a more recent tax year?
- § 418.1235— When will we stop using your more recent tax year's modified adjusted gross income to determine your income-related monthly adjustment amount?
- § 418.1240— Should you notify us if the information you gave us about your modified adjusted gross income for the more recent tax year changes?
- § 418.1245— What will happen if you notify us that your modified adjusted gross income for the more recent tax year changes?
- § 418.1250— What evidence will you need to support your request that we use a more recent tax year?
- § 418.1255— What kind of major life-changing event evidence will you need to support your request for us to use a more recent tax year?
- § 418.1260— What major life-changing event evidence will we not accept?
- § 418.1265— What kind of significant modified adjusted gross income reduction evidence will you need to support your request?
- § 418.1270— What modified adjusted gross income evidence will we not accept?
- § 418.1301— What is an initial determination regarding your income-related monthly adjustment amount?
- § 418.1305— What is not an initial determination regarding your income-related monthly adjustment amount?
- § 418.1310— When may you request that we make a new initial determination?
- § 418.1315— How will we notify you and what information will we provide about our initial determination?
- § 418.1320— What is the effect of an initial determination?
- § 418.1322— How will a Medicare prescription drug coverage income-related monthly adjustment amount determination for the effective year affect your Medicare Part B?
- § 418.1325— When may you request a reconsideration?
- § 418.1330— Can you request a reconsideration when you believe that the IRS information we used is incorrect?
- § 418.1335— What should you do if our initial determination is based on modified adjusted gross income information you believe to be incorrect?
- § 418.1340— What are the rules for our administrative review process?
- § 418.1345— Is reopening of an initial or reconsidered determination made by us ever appropriate?
- § 418.1350— What are the rules for review of a reconsidered determination or an administrative law judge decision?
- § 418.1355— What are the rules for reopening a decision by an administrative law judge of the Office of Medicare Hearings and Appeals (OMHA) or by the Medicare Appeals Council (MAC)?
Subpart C — Income-Related Monthly Adjustments to Medicare Prescription Drug Coverage Premiums
- § 418.2001— What is this subpart about?
- § 418.2005— Purpose and administration.
- § 418.2010— Definitions.
- § 418.2101— What is the income-related monthly adjustment amount?
- § 418.2105— What is the threshold?
- § 418.2110— What is the effective date of our initial determination about your income-related monthly adjustment amount?
- § 418.2112— Paying your income-related monthly adjustment amount.
- § 418.2115— What are the modified adjusted gross income ranges?
- § 418.2120— How do we determine your income-related monthly adjustment amount?
- § 418.2125— How will the income-related monthly adjustment amount affect your total Medicare prescription drug coverage premium?
- § 418.2135— What modified adjusted gross income information will we use to determine your income-related monthly adjustment amount?
- § 418.2140— What will happen if the modified adjusted gross income information from the IRS is different from the modified adjusted gross income information we used to determine your income-related monthly adjustment amount?
- § 418.2145— How do we determine your income-related monthly adjustment amount if the IRS does not provide information about your modified adjusted gross income?
- § 418.2150— When will we use your amended tax return filed with the IRS?
- § 418.2201— When will we determine your income-related monthly adjustment amount based on the modified adjusted gross income information that you provide for a more recent tax year?
- § 418.2205— What is a major life-changing event?
- § 418.2210— What is not a major life-changing event?
- § 418.2215— What is a significant reduction in your income?
- § 418.2220— What is not a significant reduction in your income?
- § 418.2225— Which more recent tax year will we use?
- § 418.2230— What is the effective date of an income-related monthly adjustment amount initial determination based on a more recent tax year?
- § 418.2235— When will we stop using your more recent tax year's modified adjusted gross income to determine your income-related monthly adjustment amount?
- § 418.2240— Should you notify us if the information you gave us about your modified adjusted gross income for the more recent tax year changes?
- § 418.2245— What will happen if you notify us that your modified adjusted gross income for the more recent tax year changes?
- § 418.2250— What evidence will you need to support your request that we use a more recent tax year?
- § 418.2255— What kind of evidence of a major life-changing event will you need to support your request for us to use a more recent tax year?
- § 418.2260— What major life-changing event evidence will we not accept?
- § 418.2265— What kind of evidence of a significant modified adjusted gross income reduction will you need to support your request?
- § 418.2270— What modified adjusted gross income evidence will we not accept?
- § 418.2301— What is an initial determination regarding your income-related monthly adjustment amount?
- § 418.2305— What is not an initial determination regarding your income-related monthly adjustment amount?
- § 418.2310— When may you request that we make a new initial determination?
- § 418.2315— How will we notify you and what information will we provide about our initial determination?
- § 418.2320— What is the effect of an initial determination?
- § 418.2322— How will a Medicare Part B income-related monthly adjustment amount determination for the effective year affect your Medicare prescription drug coverage?
- § 418.2325— When may you request a reconsideration?
- § 418.2330— Can you request a reconsideration when you believe that the IRS information we used is incorrect?
- § 418.2332— Can you request a reconsideration when you believe that the CMS information we used is incorrect?
- § 418.2335— What should you do if we base our initial determination on modified adjusted gross income information you believe to be incorrect?
- § 418.2340— What are the rules for our administrative review process?
- § 418.2345— Is reopening of an initial or reconsidered determination made by us ever appropriate?
- § 418.2350— What are the rules for review of a reconsidered determination or an ALJ decision?
- § 418.2355— What are the rules for reopening a decision by an ALJ of the Office of Medicare Hearings and Appeals (OMHA) or by the Medicare Appeals Council (MAC)?
Subpart D — Medicare Part D Subsidies
- § 418.3001— What is this subpart about?
- § 418.3005— Purpose and administration of the program.
- § 418.3010— Definitions.
- § 418.3101— How do you become eligible for a subsidy?
- § 418.3105— Who does not need to file an application for a subsidy?
- § 418.3110— What happens when you apply for a subsidy?
- § 418.3115— What events will make you ineligible for a subsidy?
- § 418.3120— What happens if your circumstances change after we determine you are eligible for a subsidy?
- § 418.3123— When is a change in your subsidy effective?
- § 418.3125— What are redeterminations?
- § 418.3201— Must you file an application to become eligible for a subsidy?
- § 418.3205— What makes an application a claim for a subsidy?
- § 418.3210— What is a prescribed application for a subsidy?
- § 418.3215— Who may file your application for a subsidy?
- § 418.3220— When is your application considered filed?
- § 418.3225— How long will your application remain in effect?
- § 418.3230— When will we use your subsidy inquiry as your filing date?
- § 418.3301— What is income?
- § 418.3305— What is not income?
- § 418.3310— Whose income do we count?
- § 418.3315— What is earned income?
- § 418.3320— How do we count your earned income?
- § 418.3325— What earned income do we not count?
- § 418.3330— What is unearned income?
- § 418.3335— What types of unearned income do we count?
- § 418.3340— How do we count your unearned income?
- § 418.3350— What types of unearned income do we not count?
- § 418.3401— What are resources?
- § 418.3405— What types of resources do we count?
- § 418.3410— Whose resources do we count?
- § 418.3415— How do we determine countable resources?
- § 418.3420— How are funds held in financial institution accounts counted?
- § 418.3425— What resources do we exclude from counting?
- § 418.3501— What could cause us to increase or reduce your subsidy or terminate your subsidy eligibility?
- § 418.3505— How would an increase, reduction or termination affect you?
- § 418.3510— When would an increase, reduction or termination start?
- § 418.3515— How could you qualify for a subsidy again?
- § 418.3601— When do you have the right to administrative review?
- § 418.3605— What is an initial determination?
- § 418.3610— Is there administrative or judicial review for administrative actions that are not initial determinations?
- § 418.3615— Will we mail you a notice of the initial determination?
- § 418.3620— What is the effect of an initial determination?
- § 418.3625— What is the process for administrative review?
- § 418.3630— How do you request administrative review?
- § 418.3635— Can anyone request administrative review on your behalf?
- § 418.3640— How do we determine if you had good cause for missing the deadline to request administrative review?
- § 418.3645— Can you request that the decision-maker be disqualified?
- § 418.3650— How do we make our decision upon review?
- § 418.3655— How will we notify you of our decision after our review?
- § 418.3665— Can your request for a hearing or case review be dismissed?
- § 418.3670— How will you be notified of the dismissal?
- § 418.3675— How does our decision affect you?
- § 418.3678— What is the process for correcting Agency clerical errors?
- § 418.3680— What happens if your case is remanded by a Federal court?