U.S. Code of Federal Regulations

Regulations most recently checked for updates: Jan 21, 2026

All TitlesTitle 20Chapter IIIPart 418Subpart C - Subpart C—Income-Related Monthly Adjustments to Medicare Prescription Drug Coverage Premiums

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 -
§ 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)?
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