---
kind: "range"
citation: "20 C.F.R. §§ 418.1201–418.1270"
title: "20"
from: "418.1201"
to: "418.1270"
count: 15
url: "https://uscodex.org/cfr/20/418.1201..418.1270"
---

# §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?


We will use a more recent tax year than the years described in § [418.1135(a)](/cfr/20/418.1135.md?p=a) or [(b)](/cfr/20/418.1135.md?p=b) to reduce or eliminate your income-related monthly adjustment amount when all of the following occur:

- (a) You experience a major life-changing event as defined in [§ 418.1205](/cfr/20/418.1205.md); and
- (b) That major life-changing event results in a significant reduction in your modified adjusted gross income for the year which you request we use and the next year, if applicable. For purposes of this section, a significant reduction in your modified adjusted gross income is one that results in the decrease or elimination of your income-related monthly adjustment amount; and
- (c) You request that we use a more recent tax year's modified adjusted gross income; and
- (d) You provide evidence as described in §§ [418.1255](/cfr/20/418.1255.md) and [418.1265](/cfr/20/418.1265.md).

# §418.1205. What is a major life-changing event?


For the purposes of this subpart, we will consider the following to be major life-changing events:

- (a) Your spouse dies;
- (b) You marry;
- (c) Your marriage ends through divorce or annulment;
- (d) You or your spouse stop working or reduce the hours you work;
- (e) You or your spouse experiences a loss of income-producing property, provided the loss is not at the direction of you or your spouse (e.g., due to the sale or transfer of the property) and is not a result of the ordinary risk of investment. Examples of the type of property loss include, but are not limited to: Loss of real property within a Presidentially or Gubernatorially-declared disaster area, destruction of livestock or crops by natural disaster or disease, loss from real property due to arson, or loss of investment property as a result of fraud or theft due to a criminal act by a third party;
- (f) You or your spouse experiences a scheduled cessation, termination, or reorganization of an employer's pension plan;
- (g) You or your spouse receives a settlement from an employer or former employer because of the employer's closure, bankruptcy, or reorganization.

# §418.1210. What is not a major life-changing event?


We will not consider events other than those described in [§ 418.1205](/cfr/20/418.1205.md) to be major life-changing events. Certain types of events are not considered major life-changing events for the purposes of this subpart, such as:

- (a) Events that affect your expenses, but not your income; or
- (b) **Events that result in the loss of dividend income because of the ordinary risk of investment.**

# §418.1215. What is a significant reduction in your income?


For purposes of this subpart, we will consider a reduction in your income to be significant if your modified adjusted gross income decreases; and

- (a) The decrease reduces the percentage of the income-related monthly adjustment amount you must pay according to the Table of Applicable Percentages in [§ 418.1120](/cfr/20/418.1120.md); or
- (b) The decrease reduces your modified adjusted gross income to an amount below the threshold described in [§ 418.1105](/cfr/20/418.1105.md) and eliminates any income-related monthly adjustment amount you must pay.

# §418.1220. What is not a significant reduction in your income?


For purposes of this subpart, we will not consider a reduction in your income to be significant unless the reduction affects the amount of income-related monthly adjustment you must pay.


# §418.1225. Which more recent tax year will we use?


We will consider evidence of your modified adjusted gross income that you provide for a tax year that is more recent than the year described in § [418.1135 (a)](/cfr/20/418.1135.md?p=a) or [(b)](/cfr/20/418.1135.md?p=b) when you meet all of the requirements described in [§ 418.1201](/cfr/20/418.1201.md). We will always ask you for your retained copy of your filed Federal income tax return for the more recent year you request that we use and will use that information to make an initial determination. If you have not filed your Federal income tax return for the more recent year you request that we use, you must provide us with evidence that is equivalent to a copy of a filed Federal income tax return. Evidence that is equivalent to a copy of a filed Federal income tax return is defined in [§ 418.1265(c)](/cfr/20/418.1265.md?p=c).


# §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?

- (a) Subject to [paragraph (b)](#b) of this section, when your modified adjusted gross income for the more recent tax year is significantly reduced as a result of a major life-changing event, our initial determination is generally effective on January 1 of the year in which you make your request. If your first month of enrollment or reenrollment in Medicare Part B is after January of the year for which you make your request, our initial determination is effective on the first day of your Medicare Part B enrollment or reenrollment.
- (b) We will make a determination about your income-related monthly adjustment amount for the year preceding the year that you make your request in the limited circumstances explained in [§ 418.1310(a)(4)](/cfr/20/418.1310.md?p=a-4). When we make a determination for the preceding year, our initial determination is generally effective on January 1 of that year. If your first month of enrollment or reenrollment in Medicare Part B is after January of that year, our initial determination is effective on the first day of your Medicare Part B enrollment or reenrollment.
- (c) Our initial determination will be effective January 1 of the year following the year you make your request, when your modified adjusted gross income will not be significantly reduced as a result of one or more of the events described in [§ 418.1205(a) through (g)](/cfr/20/418.1205.md?p=a..g) until the year following the year you make your request.

# §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?


We will use your more recent tax year's modified adjusted gross income to determine your income-related monthly adjustment amount effective with the month and year described in [§ 418.1230](/cfr/20/418.1230.md) and for each year thereafter until one of the following occurs:

- (a) We receive your modified adjusted gross income from IRS for the more recent tax year we used or a later tax year;
- (b) Your more recent tax year modified adjusted gross income that we used is for a tax year more than 3 years prior to the income-related monthly adjustment amount effective year;
- (c) You request we use a more recent tax year based on another major life-changing event as described in [§ 418.1201](/cfr/20/418.1201.md); or
- (d) You notify us of a change in your modified adjusted gross income for the more recent tax year we used as described in [§ 418.1240](/cfr/20/418.1240.md).

# §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?


If you know that the information you provided to us about the more recent tax year that we used has changed, you should tell us so that we can determine if your income-related monthly adjustment amount should be eliminated or adjusted. We will accept new modified adjusted gross income information at any time after your request until the end of the calendar year following the more recent tax year(s) that we used. For us to make a new initial determination using your new modified adjusted gross income information, you must provide evidence as described in [§ 418.1265](/cfr/20/418.1265.md) to support the reduction or increase in your modified adjusted gross income. If you amend your Federal income tax return for the more recent tax year we used, we will use the rules in [§ 418.1150](/cfr/20/418.1150.md).


# §418.1245. What will happen if you notify us that your modified adjusted gross income for the more recent tax year changes?

- (a) If you notify us that your modified adjusted gross income for the more recent tax year has changed from what is in our records, we may make a new initial determination for each effective year involved. To make a new initial determination(s) we will take into account:
  - (1) The new modified adjusted gross income information for the more recent tax year you provide; and
  - (2) Any modified adjusted gross income information from IRS, as described in [§ 418.1135](/cfr/20/418.1135.md), that we have available for each effective year; and
  - (3) Any modified adjusted gross income information from you, as described in [§ 418.1135](/cfr/20/418.1135.md), that we have available for each effective year.
- (b) For each new initial determination that results in a change in your income-related monthly adjustment amount, we will make retroactive adjustments that will apply to all enrolled months of the effective year.
- (c) We will continue to use a new initial determination described in [paragraph (a)](#a) of this section to determine additional yearly income-related monthly adjustment amount(s) until an event described in [§ 418.1235](/cfr/20/418.1235.md) occurs.
- (d) We will make a new determination about your income-related monthly adjustment amount when we receive modified adjusted gross income for the effective year from IRS, as described in [§ 418.1140(d)](/cfr/20/418.1140.md?p=d).

# §418.1250. What evidence will you need to support your request that we use a more recent tax year?


When you request that we use a more recent tax year to determine your income-related monthly adjustment amount, we will ask for evidence of the major life-changing event and how the event significantly reduced your modified adjusted gross income as described in §§ [418.1255](/cfr/20/418.1255.md) and [418.1265](/cfr/20/418.1265.md). Unless we have information in our records that raises a doubt about the evidence, additional evidence documenting the major life-changing event(s) will not be needed.


# §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?

- (a) If your spouse died and we do not have evidence of the death in our records, we will require proof of death as described in § [404.720(b)](/cfr/20/404.720.md?p=b) or [(c)](/cfr/20/404.720.md?p=c) or [§ 404.721](/cfr/20/404.721.md) of this chapter.
- (b) If you marry and we do not have evidence of the marriage in our records, we will require proof of marriage as described in [§§ 404.725 through 404.727](/cfr/20/404.725..404.727.md) of this chapter.
- (c) If your marriage ends and we do not have evidence that the marriage has ended in our records, we will require proof that the marriage has ended as described in § [404.728(b)](/cfr/20/404.728.md?p=b) or [(c)](/cfr/20/404.728.md?p=c) of this chapter.
- (d) If you or your spouse stop working or reduce your work hours, we will require evidence documenting the change in work activity. Examples of acceptable documentation include, but are not limited to, documents we can corroborate such as a signed statement from your employer, proof of the transfer of your business, or your signed statement under penalty of perjury, describing your work separation or a reduction in hours.
- (e) If you or your spouse experiences a loss of income-producing property, we will require evidence documenting the loss. Examples of acceptable evidence include, but are not limited to, insurance claims or an insurance adjuster's statement. If the claim of loss is due to criminal fraud or theft by a third party, we will also require proof of conviction for the fraud or theft, such as a court document.
- (f) If you or your spouse experiences a scheduled cessation, termination, or reorganization of an employer's pension plan, we will require evidence documenting the change in or loss of the pension. An example of acceptable evidence includes, but is not limited to, a statement from your pension fund administrator explaining the reduction or termination of your benefits.
- (g) If you or your spouse receives a settlement from an employer or former employer because of the employer's closure, bankruptcy, or reorganization, we will require evidence documenting the settlement and the reason(s) for the settlement. An example of acceptable evidence includes, but is not limited to, a letter from the former employer stating the settlement terms and how they affect you or your spouse.

# §418.1260. What major life-changing event evidence will we not accept?

- (a) We will not accept evidence of death that fails to meet the requirements in [§§ 404.720 through 404.721](/cfr/20/404.720..404.721.md) of this chapter.
- (b) We will not accept evidence of marriage that fails to meet the requirements in [§§ 404.725 through 404.727](/cfr/20/404.725..404.727.md) of this chapter.
- (c) We will not accept evidence that your marriage has ended if the evidence fails to meet the requirements in [§ 404.728](/cfr/20/404.728.md) of this chapter.
- (d) We will not accept documents supporting loss of income from income-producing property, or failure of or loss from a defined benefit pension plan unless the documents are original documents or copies from the original source.
- (e) We will not accept evidence of work reduction or work stoppage that cannot be substantiated.

# §418.1265. What kind of significant modified adjusted gross income reduction evidence will you need to support your request?

- (a) You must provide evidence that one or more of the major life-changing events described in [§ 418.1205](/cfr/20/418.1205.md) resulted in a significant reduction in your modified adjusted gross income for the tax year you request we use.
- (b) The preferred evidence is your retained copy of your filed Federal income tax return, your retained copy of your amended tax return with an IRS letter of receipt of the amended tax return, your copy of proof of a correction of the IRS information we used or a copy of your return or amended or proof of a correction of tax return information that you obtain from IRS for the more recent tax year you request we use.
- (c) When a copy of your filed Federal income tax return is not available for the more recent tax year in which your modified adjusted gross income was significantly reduced, we will accept equivalent evidence. Equivalent evidence is the appropriate proof(s) in paragraphs [(c)(1)](#c-1), [(2)](#c-2) and [(3)](#c-3) of this section, plus your signed statement under penalty of perjury that the information you provide is true and correct. When the major life-changing event changes your tax filing status, or the income-related monthly adjustment amount determination could be affected by your tax filing status, you will also be required to sign a statement regarding your intended income tax filing status for the tax year you request we use.
  - (1) If you experience one or more of the events described in § [418.1205(a)](/cfr/20/418.1205.md?p=a), [(b)](/cfr/20/418.1205.md?p=b), or [(c)](/cfr/20/418.1205.md?p=c), you must provide evidence as to how the event(s) significantly reduced your modified adjusted gross income. Examples of the type of evidence include, but are not limited to, evidence of your spouse's modified adjusted gross income and/or your modified adjusted gross income for the tax year we use.
  - (2) If you experience one or more of the events described in § [418.1205(d)](/cfr/20/418.1205.md?p=d), [(e)](/cfr/20/418.1205.md?p=e), [(f)](/cfr/20/418.1205.md?p=f), or [(g)](/cfr/20/418.1205.md?p=g), you must provide evidence of how the event(s) significantly reduced your modified adjusted gross income, such as a statement explaining any modified adjusted gross income changes for the tax year we used and a copy of your filed Federal income tax return (if you have filed one).
  - (3) If your spouse experiences one or more of the events described in § [418.1205(d)](/cfr/20/418.1205.md?p=d), [(e)](/cfr/20/418.1205.md?p=e), [(f)](/cfr/20/418.1205.md?p=f), or [(g)](/cfr/20/418.1205.md?p=g), you must provide evidence of the resulting significant reduction in your modified adjusted gross income. The evidence requirements are described in [paragraph (c)(2)](#c-2) of this section.
- (d) When we use information described in [paragraph (c)](#c) of this section, we will request that you provide your retained copy of your Federal income tax return for the year we used when you file your taxes. We will use that information to make timely adjustments to your Medicare premium, if necessary. We will later verify the information you provide when we receive information about that tax year from IRS, as described in [§ 418.1140(d)](/cfr/20/418.1140.md?p=d).

# §418.1270. What modified adjusted gross income evidence will we not accept?


We will not accept a correction or amendment of your income tax return without a letter from IRS acknowledging the change. We will also not accept illegible or unsigned copies of income tax returns or attestations or other statements of income unless they are provided under penalty of perjury.