What is Form SSA-44?
Form SSA-44, "Medicare Income-Related Monthly Adjustment Amount – Life-Changing Event," is how you ask SSA to use a more recent tax year to decide your income-related monthly adjustment amount (IRMAA), the surcharge added to Part B and Part D premiums above the income thresholds[ssa44]. SSA calls the result a new initial determination; it is not an appeal, and using the form is optional, since you can also ask at an interview[hi001].
You can use the SSA-44 form when four things are true: you received an IRMAA notice, one of the eight events happened, the event lowered your modified adjusted gross income (MAGI) enough to drop at least one bracket, and you can show evidence of both[cfr1201][cfr1215]. If you pay no IRMAA (MAGI of $109,000 or less, or $218,000 joint, for 2026), SSA asks you not to file it[ssa44]. The brackets are on the IRMAA brackets 2026 page and the base premium on the Medicare Part B premium page.
| Item | Rule |
|---|---|
| Who files | A Medicare beneficiary paying IRMAA; each spouse files their own request |
| Income used without the form | 2024 return for 2026 premiums (2023 if 2024 is not available) |
| Newer year you can ask for | 2025 (actual) or 2026 (estimate) |
| Counts as a drop | Only a change that lowers your bracket (20 CFR 418.1215) |
| Effective | January 1 of the year you ask, or your first Part B month |
The 8 IRMAA life-changing events
An IRMAA life-changing event is one of exactly eight situations SSA accepts: marriage, divorce or annulment, death of a spouse, work stoppage, work reduction, loss of income-producing property, loss of pension income and an employer settlement payment[cfr1205][hi005]. The regulation has seven paragraphs; the form splits stopping and reducing work into two boxes.
| Box on the form | Typical situation | Proof SSA asks for |
|---|---|---|
| Marriage | You married and your filing status changes | Marriage certificate |
| Divorce/Annulment | Your marriage ended and you no longer file jointly | Certified decree |
| Death of Your Spouse | Widowed; often also a move from joint to single thresholds | Certified death certificate |
| Work Stoppage | Retirement, layoff, or selling your business (you or your spouse) | Employer or retirement letter, or your signed statement |
| Work Reduction | Part-time work, fewer hours or a lower-paid job (you or your spouse) | Employer letter or pay stubs, or your signed statement |
| Loss of Income-Producing Property | Rental, farm or business property lost to disaster, disease, arson, eminent domain or crime | Insurance adjuster or government letter; conviction record for fraud or theft |
| Loss of Pension Income | A defined benefit or cash balance pension cut, ended or reached a scheduled end | Pension administrator letter |
| Employer Settlement Payment | A payment from an employer that closed, went bankrupt or reorganized | Employer letter or court record of the terms |
The list is exclusive. Events that raise costs but not income, lower dividends and normal market losses do not count[cfr1210]. SSA also names one-time income as non-qualifying: capital gains from selling property, lottery or casino winnings, cashing bonds and converting an IRA[hi005]. Pension losses count only for defined benefit and cash balance plans[hi040]. If a Roth conversion caused your surcharge, the form will not help; the IRMAA falls away when SSA receives the lower later return.
Form SSA-44 instructions, step by step
The form has five steps and takes SSA's estimate of about 45 minutes, most of it gathering documents[ssa44]. Write your full name and your own Social Security number at the top, as on your Social Security card.
- Step 1, event. Check the box and write the month and year (mm/yyyy). The event must be in the same year as, or earlier than, the tax year you enter in Step 2; it can be years in the past[ssa44][hi005].
- Step 2, income that already dropped. Enter the tax year, your adjusted gross income from Form 1040 line 11, tax-exempt interest from line 2a and your filing status. Pick 2026 (an estimate) if your income fell this year or will fall further; pick 2025 if it fell then and will not be lower in 2026.
- Step 3, next year. Fill it in only if you expect the following year to be lower still; otherwise SSA reuses Step 2 next year.
- Step 4, evidence. Attach originals or certified copies of the event proof and your signed tax return or IRS transcript (SSA mails originals back), or show them at an office. With an estimate, send the signed return after you file[cfr1255].
- Step 5, signature. Sign, and add your phone number and mailing address. The signature is a declaration under penalty of perjury, which is also how SSA accepts your own statement about a work stoppage or reduction[hi030].
Worked example. A single filer with $180,000 of 2024 MAGI pays $527.50 for Part B and $60.40 extra for Part D in 2026: $385.00 a month of IRMAA. After retiring in June 2025, the filer's 2025 AGI was $95,000, so the form gets Work Stoppage (06/2025) in Step 1 and 2025 in Step 2. If SSA agrees, the premium drops to the standard premium, $4,620.00 a year less.
Where to send Form SSA-44 and what happens next
Send or take Form SSA-44 and your evidence to your local Social Security office (find it with SSA's office locator), or call 1-800-772-1213 (TTY 1-800-325-0778) to set up an interview instead[ssa44][hi001]. Download the current form from ssa.gov/forms/ssa-44.pdf; we do not reproduce it.
- Effective date. An approved request generally applies from January 1 of the year you make it, or your first month of Part B that year[cfr1230]. An event in October–December can reach back to that year if SSA gets the request by March 31[hi005].
- How long it lasts. SSA keeps using your newer-year figure until the IRS reports that year, you send a different return or you give a new estimate; a wrong estimate is corrected later, up or down[ssa44].
- Spouses. A decision covers only the person who asks, so a spouse who also pays IRMAA files separately[hi001].
How to appeal IRMAA: SSA-44 or reconsideration?
To appeal IRMAA you either file Form SSA-44 for a life-changing event, or request reconsideration when the IRS figures SSA used are wrong, for example after an amended return; SSA says the new determination usually gets the same result as an appeal, and you can file both at once[hi140][hi001]. If SSA denies an SSA-44 request and the appeal period has passed, it treats that as good cause for a late reconsideration request[hi140]. An IRMAA appeal letter is optional: the form and the evidence carry the request, and a short cover letter only lists what you enclosed. If your letter is about a Social Security overpayment instead, the forms are SSA-561, SSA-632-BK and SSA-634.
Not legal or tax advice.This page explains the published SSA rules. SSA alone decides your IRMAA; check your own notice for the tax year and amounts it used.
Check your event and get Form SSA-44 filled in line by line
Frequently asked questions
What is Form SSA-44 used for?
To ask Social Security to recalculate your Medicare IRMAA from a newer, lower year of income after one of eight life-changing events, instead of the tax return from two years earlier[ssa44].
How do I appeal IRMAA?
If a life-changing event lowered your income, file Form SSA-44 with proof of the event and the newer income. If the IRS income SSA used is wrong, request reconsideration; you can do both[hi140].
What counts as an IRMAA life-changing event?
Marriage, divorce or annulment, death of a spouse, work stoppage, work reduction, loss of income-producing property, loss of pension income and an employer settlement payment[cfr1205]. Roth conversions and capital gains do not count.
Where do I send Form SSA-44?
To your local Social Security office, by mail or in person, with your evidence. You can also call 1-800-772-1213 to set up an interview instead of using the form.
Do I need an IRMAA appeal letter?
No. Form SSA-44 and the evidence are the request. A cover letter that lists the enclosures is optional but helps if documents get separated.
Sources
- Form SSA-44 (12-2025), Medicare Income-Related Monthly Adjustment Amount – Life-Changing Event, with instructions
- 20 CFR § 418.1201, When will we determine your IRMAA based on information for a more recent tax year?
- 20 CFR § 418.1205, What is a major life-changing event?
- 20 CFR § 418.1210, What is not a major life-changing event?
- 20 CFR §§ 418.1215–418.1220, What is (and is not) a significant reduction in your income?
- 20 CFR § 418.1230, Effective date of a determination based on a more recent tax year
- 20 CFR §§ 418.1255–418.1270, Life-changing event and income evidence
- POMS HI 01120.001, Overview of new initial determinations on the IRMAA using beneficiary-provided information
- POMS HI 01120.005, Life changing events (eight events, non-qualifying events, effective dates)
- POMS HI 01120.025–.030, Work reduction and work stoppage (evidence)
- POMS HI 01120.040, Reduction or loss of pension income
- POMS HI 01140.005, The reconsideration process for the IRMAA
- 2026 Medicare Parts A & B Premiums and Deductibles (fact sheet)