Code of Federal Regulations > Title 20 > Chapter III > Part 418 > Subpart C - Subpart C—Income-Related Monthly Adjustments to Medicare Prescription Drug Coverage Premiums

U.S. Code of Federal Regulations

Regulations most recently checked for updates: Aug 28, 2025

INTRODUCTION, GENERAL PROVISIONS, AND DEFINITIONS

§ 418.2001 - What is this subpart about?

§ 418.2005 - Purpose and administration.

§ 418.2010 - Definitions.

DETERMINATION OF THE INCOME-RELATED MONTHLY ADJUSTMENT AMOUNT

§ 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?

DETERMINATIONS USING A MORE RECENT TAX YEAR'S MODIFIED ADJUSTED GROSS INCOME

§ 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?

DETERMINATIONS AND THE ADMINISTRATIVE REVIEW PROCESS

§ 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)?