Form SSA-44: how to fill it out and lower your IRMAA
SSA-44Ed. 12-2025
Form SSA-44 asks Social Security to set your Medicare IRMAA surcharge from your current, lower income instead of your income from two years ago. You can use it if your income dropped because of one of 8 life-changing events, such as retiring.
What this form does
Do you qualify?
You qualify if your income went down because of one of these events, and the event happened in or before the year you ask Social Security to use. Each one has its own page with a worked example: see all 8 life-changing events.
- Marriage
- Divorce or annulment
- Death of your spouse
- You stopped working (retired)
- You cut back your work hours
- You lost income from property because of a disaster, fraud, or theft
- Your pension stopped or was cut
- You received a settlement payment from an employer that closed or went bankrupt
These do not qualify
How to fill out Form SSA-44, step by step
The form has 5 steps. Here is a filled example for someone who retired in June 2025 and files single.
Step 1: Type of life-changing event
Tick the event that caused your income to drop, and write the month and year it happened (mm/yyyy).
Step 2: Reduction in income that has already happened
Enter the tax year when your income went down, your adjusted gross income (Form 1040, line 11) and your tax-exempt interest (line 2a) for that year, and your filing status.
Step 3: Expected lower income next year
Answer yes only if the year after your Step 2 year will be lower still, and give an estimate for it. Our retiree expects 2026 to be about the same as 2025 (pension, Social Security and IRA withdrawals), so he answers no.
Step 4: Documents
You need two kinds of proof: proof of your income, and proof of the event.
- Income: a signed copy of your filed tax return for the Step 2 year, or an IRS tax transcript.
- The event: see the table below.
| Event | What to send |
|---|---|
| Marriage | Original marriage certificate, or a certified copy of the public record |
| Divorce or annulment | Certified copy of the divorce or annulment decree |
| Death of your spouse | Certified death certificate, public record of death, or coroner's certificate |
| Work stoppage (you retired or stopped working) | Signed letter from your employer, pay stubs, or papers showing you sold or transferred your business. If you have none, you can sign a statement on the form. |
| Work reduction (you cut back hours) | Same as work stoppage |
| Loss of income-producing property | Insurance adjuster's statement of loss, or a government letter. For investment fraud or theft, also proof of conviction. |
| Loss of pension income | Letter or statement from the pension administrator |
| Employer settlement payment | Letter from the employer explaining the bankruptcy or reorganization settlement |
Send copies. If you send originals or certified copies, Social Security mails them back.
Step 5: Sign
Sign and date the form and add your phone number and mailing address. Social Security checks what you wrote against IRS records.
How to submit Form SSA-44
- Online (fastest)Sign in to your my Social Security account and start a request from the lower IRMAA page. You upload your documents.
- By mail or in personSend the form and copies of your documents to your local Social Security office, or bring them in. Find yours with the office locator. There is no national mailing address for this form.
- Keep copiesKeep a copy of everything you send and write down the date. You'll need it if you have to follow up.
What happens next
Social Security sends you a letter with their decision. If they agree, your premium is recalculated from the lower income, and the change usually applies back to January of that year. If they say no, the letter explains why. You can ask for reconsideration if they used wrong information.
Want to see how much you could save first? Use the IRMAA bracket calculator.
The lowest IRMAA bracket costs $81.20 a month in 2026. If your request is approved, the kit pays for itself in the first month.
Everything you need to fill out Form SSA-44, prove your life-changing event, and stop paying a surcharge based on income you no longer have.
- SSA-44 walkthrough for all 8 life-changing events
- Evidence checklist for your event
- What gets rejected, and why
- Income estimate worksheet
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The official forms are free from ssa.gov and cms.gov. The kit is the help filling them in and proving your case. See everything inside
Questions people ask
Where do I get Form SSA-44?
It is free on ssa.gov as a PDF. You can also skip the paper form and file online after signing in to your my Social Security account.
How long does Social Security take to decide?
It varies by office. Keep a copy of everything you send and the date you sent it. If you hear nothing after about 60 days, contact your local office.
Can I file SSA-44 before I get an IRMAA letter?
Yes. You can file as soon as the life-changing event has happened and your income has dropped. Many people file right after they retire.
My income was high because of a Roth conversion. Will SSA-44 help?
No. A Roth conversion is not one of the 8 life-changing events, so Social Security will not use it to lower IRMAA. The higher income drops off on its own two years later.
What if Social Security says no?
The letter explains why. If they used wrong information, you can ask for reconsideration. If your event didn't qualify, a new request with the same facts will not help.
Do I need to file SSA-44 every year?
Usually not. Once Social Security uses your lower income, later years are based on your actual tax returns, which already show the lower income.