Personal Interview (SSA Field Office)

Medicare Income-Related Monthly Adjustment Amount - Life-Changing Event

IRMAA Online Screens - 0960-0784

Personal Interview (SSA Field Office)

OMB: 0960-0784

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IRMAA Online Screens: 0960-0784 January 2017
IRSU
The IRSU screen displays the INCOME RELATED MONTHLY ADJUSTMENT AMOUNT
(IRMAA) menu.
Select 02 (TITLE II/PE/MONET/IRMAA) from the SSA Menu

IRMAA Online Screens

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

IRMAA Online Screens

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Select F1 Key to access the HELP screen

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Select ENTER

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IRCA
The IRCA screen is an online IRMAA calculator used to determine an individual’s IRMAA level,
and associated cost.
Select 02 (TITLE II/PE/MONET/IRMAA) from the SSA Menu

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

IRMAA Online Screens

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

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

Select Enter

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IRIA
The IRIA screen is used to manually compute and process a change to the current IRMAA
level.
Select 02 (TITLE II/PE/MONET/IRMAA) from the SSA Menu

IRMAA Online Screens

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

IRMAA Online Screens

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

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Enter Unit code, Beneficiary SSN, Select 1: ESTABLISH, Premium year affected 3: MANUAL
IRMAA ADJUSTMENT, then select 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.)

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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 then select Enter.

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Next, is a redirection to the main menu. If the 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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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.

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

IRMAA Online Screens

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

IRMAA Online Screens

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

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.

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

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

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

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

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

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

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IRMAA Online Screens

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References:
IRSU

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IRCA

IRIA

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IRRE

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File Typeapplication/pdf
AuthorMurphy, Donald X.
File Modified2017-05-03
File Created2017-05-03

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