Personal Interview (SSA Field Office)

IRMAA Online Screen Changes: Release November 2010
Note:
Modifications will be made to the following IRMAA online screens for November 2010: IRSU, IRCA, IRIA and IRRE.
Each screen scenario contains images with the expected changes for November. For comparison, a reference
section is attached containing images of the previous IRCA, IRIA and IRRE screens without the November 2010
changes.

IRSU
The IRSU screen displays the INCOME RELATED MONTHLY ADJUSTMENT AMOUNT (IRMAA)
menu. Changes were made to add Part D information to page 2 of the F1 help screen.
Select 02 (TITLE II/PE/MONET/IRMAA) from the SSA Menu

ORSIS/DMPT2S/MPB-IRMAA Online Screen Changes 11/2010
Analyst: C. Kendall

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Select 3=INCOME RELATED MONTHLY ADJUSTMENT AMOUNT (IRMAA) from the TITLE II
POSTENTITLEMENT MENU.

Press F1 Key to access the HELP screen

ORSIS/DMPT2S/MPB-IRMAA Online Screen Changes 11/2010
Analyst: C. Kendall

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(Page 1 of 2 –no changes were made to this page.) ENTER

Part D Premium data added to Page 2 of 2

ORSIS/DMPT2S/MPB-IRMAA Online Screen Changes 11/2010
Analyst: C. Kendall

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IRCA
The IRCA screen is an online IRMAA calculator that is used to determine an individual’s IRMAA level,
and its associated cost. Changes include a separate field for the Part B and Part D IRMAA Amounts.
Test Scenario: Beneficiary reports a single filing status for Premium Year 2011. The adjusted gross
income is projected as $500,000.00 with tax-exempt interest equal to $65,000.00.
Results: Beneficiaries’ total MAGI for Premium year 2011 are computed as $565,000. As a result, NH will
be subject to level 4 IRMAA. $255.10 will be applied to the Part B Premium and $71.40 will be applied to
the Part D Premium.

Select 02 (TITLE II/PE/MONET/IRMAA) from the SSA Menu

ORSIS/DMPT2S/MPB-IRMAA Online Screen Changes 11/2010
Analyst: C. Kendall

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Select 3=INCOME RELATED MONTHLY ADJUSTMENT AMOUNT (IRMAA) from the TITLE II
POSTENTITLEMENT MENU.

Select 3=CALCULATOR from the INCOME RELATED MONTHLY ADJUSTMENT AMOUNT (IRMAA) MENU.

ORSIS/DMPT2S/MPB-IRMAA Online Screen Changes 11/2010
Analyst: C. Kendall

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Enter Claimant’s: filing status, Premium Year affected Adjusted Gross Income, and Tax Exempt Interest.
Press enter for new IRMAA calculation results.

Enter

ORSIS/DMPT2S/MPB-IRMAA Online Screen Changes 11/2010
Analyst: C. Kendall

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IRIA
The IRIA is used to manually compute and process a change to the current IRMAA level.
Changes include separate IRMAA levels listed for Part B and Part D.
Test Scenario: Based on 2009 tax data (Adjusted Gross Income (AGI) = $100,000.00 and Tax Exempt
Interest (TEI) = $80,000.00), beneficiary is currently subject to level 1 IRMAA for premium year 2011.
On 9/14/2010, beneficiary reports a projected increase in income for the 2011 tax year. The
new estimated AGI= $450,000.00 with a TEI of $50,000.00. Based on filing status “single”, a
manual IRMAA adjustment is done to increase the individuals IRMAA level.

Select 02 (TITLE II/PE/MONET/IRMAA) from the SSA Menu

ORSIS/DMPT2S/MPB-IRMAA Online Screen Changes 11/2010
Analyst: C. Kendall

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Select 3=INCOME RELATED MONTHLY ADJUSTMENT AMOUNT (IRMAA) from the TITLE II
POSTENTITLEMENT MENU.

Select 1=MAIN MENU from the INCOME RELATED MONTHLY ADJUSTMENT AMOUNT (IRMAA)
MENU.

ORSIS/DMPT2S/MPB-IRMAA Online Screen Changes 11/2010
Analyst: C. Kendall

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Enter Unit code, Beneficiary SSN, 1=ESTABLISH, Premium year affected, 3=MANUAL IRMAA
ADJUSTMENT, and enter

Screen will display current IRMAA data. Enter Beneficiary report date, tax year, Adjusted Gross
Income, Tax Exempt Interest, filing status, and select an IRMAA level. (In unsure of correct
IRMAA level, use calculator (IRCA Screen) to determine correct level based on the AGI and TEI.)

ORSIS/DMPT2S/MPB-IRMAA Online Screen Changes 11/2010
Analyst: C. Kendall

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The IRRE screen will display the old and new IRMAA data, and provide the new determination
results. To complete the transaction and update changes to the record enter a “y” in the
“PROCESS ALL TRANSACTIONS (Y/N)” field, and enter.

ORSIS/DMPT2S/MPB-IRMAA Online Screen Changes 11/2010
Analyst: C. Kendall

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You will then be redirected to the main menu. If transaction processed successfully, a note
stating, “TRANSACTION PROCESSED SUCCESSFULLY-PRESS ANY PF KEY TO ENTER EVID” will be
displayed on the bottom of the screen in red.

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Analyst: C. Kendall

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IRRE
IRRE screen appears in the path of a Life Changing Event (LCE) and a Manual IRMAA
Adjustment. It shows you current IRMAA data (if available) and shows recalculated data
based on the entries made in the data collection process. The IRRE screen also allows you to
process dismissals and updates to a beneficiary’s IRMAA.
Test Scenario: NH is currently charged Level 3 IRMAA. He reports LCE for the 2010 tax year,
2011 Premium year. NH married and provided estimated tax data. NH’s AGI is $600,000.00 with
a TEI of $40,000.00. Filing status is married filing separately.
Results: LCE is keyed with the estimated tax data, and results in a dismissal.

Select 02 (TITLE II/PE/MONET/IRMAA) from the SSA Menu

ORSIS/DMPT2S/MPB-IRMAA Online Screen Changes 11/2010
Analyst: C. Kendall

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Select 3=INCOME RELATED MONTHLY ADJUSTMENT AMOUNT (IRMAA) from the TITLE II
POSTENTITLEMENT MENU.

Select 1=MAIN MENU from the INCOME RELATED MONTHLY ADJUSTMENT AMOUNT (IRMAA)
MENU.

ORSIS/DMPT2S/MPB-IRMAA Online Screen Changes 11/2010
Analyst: C. Kendall

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Enter UNIT Code, BENEFICIARY SSN, 1=ESTABLISH, Premium Year, 1=LIFE CHANGING EVENT (for
LCE changes that may result in a dismissal) or 3=MANUAL IRMAA ADJUSTMENT (will result in an
increase or decrease of IRMAA amount). If LCE selection is made a “Tax Year” must be entered.

Select a LCE from the menu. Enter the “MMYYYY” of the event, and if proof has been attained.
Enter

ORSIS/DMPT2S/MPB-IRMAA Online Screen Changes 11/2010
Analyst: C. Kendall

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Enter a “Y/N” if Beneficiary or Representative Payee Attest that all information is true and
correct. Enter

Enter the BENEFICIARY REPORT DATE, AGI, TEI, type of tax data submitted, FILING STATUS, and
Proof of evidence. Enter

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Analyst: C. Kendall

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IRRE Screen displays prior and current IRMAA data and the new determination results. Enter a
“Y” to process transaction to completion. Enter

Determination results of “NO CHANGE” will result in a dismissal and the screen below will be
displayed.

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Analyst: C. Kendall

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If transaction processed successfully, a new IRMAA determination will be displayed, and the
following screens will appear:

ORSIS/DMPT2S/MPB-IRMAA Online Screen Changes 11/2010
Analyst: C. Kendall

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Reference:
IRSU

ORSIS/DMPT2S/MPB-IRMAA Online Screen Changes 11/2010
Analyst: C. Kendall

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IRCA

IRIA

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Analyst: C. Kendall

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IRRE

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