Form SSA-44 is officially called Medicare Income-Related Monthly Adjustment Amount – Life-Changing Event. You use it to ask Social Security to figure your IRMAA from a more recent year's income, because something major happened and your income went down.
The current edition is 12-2025 (OMB No. 0960-0784). It says “Discontinue Prior Editions,” so use this one. It's 8 pages: pages 1–3 are the form, page 4 is the privacy notice, and pages 5–8 are instructions. Social Security estimates it takes about 45 minutes. Get the PDF at ssa.gov/forms/ssa-44.pdf.
Before you start: should you file it?
Use SSA-44 if you got a notice that your Part B or drug plan premium includes IRMAA, and you had a life-changing event that may lower it. Don't use it in these cases:
- You don't pay IRMAA right now. The form says not to fill it out, even if you had a life-changing event.
- You filed “married filing separately” but lived apart from your spouse all year. That's a different request. Call 1-800-772-1213 (TTY 1-800-325-0778).
- You filed an amended tax return. Call 1-800-772-1213 and say you want to lower IRMAA because of an amended return.
- The IRS figure itself is wrong. Get it corrected with the IRS first. See what to do when you get an IRMAA letter.
Have ready: your IRMAA letter (it names the tax year used), your newer tax return or a careful estimate, and proof of your event.
Page 1: name and Social Security number
Print your full name and your own Social Security number exactly as they appear on your Social Security card. The form warns that this number may be different from the one on your Medicare card.
The page 1 table shows the 2026 IRMAA add-on amounts. There's nothing to fill in there.
Step 1: your life-changing event and its date
Check every event that applies:
- Marriage
- Divorce/Annulment
- Death of Your Spouse
- Work Stoppage
- Work Reduction
- Loss of Income-Producing Property
- Loss of Pension Income
- Employer Settlement Payment
Then write the date as mm/yyyy. If you're not sure an event counts, read our guide to the eight IRMAA life-changing events first. Some, like loss of pension income, are narrower than they sound.
The date rule
The event must happen in the same year or an earlier year than the tax year you ask Social Security to use. The form's example: if they used your 2024 income for 2026, you can ask them to use 2025 if your income dropped in 2025 because of an event in 2025 or earlier.
You can also report an event you expect. Step 2 is for income drops that have already happened. Step 3 is for drops you expect next year.
See if an SSA-44 could lower your IRMAA. Start the free IRMAA check →
Step 2: which tax year, and your income for it
Write the tax year as “20__.” It must be more recent than the year Social Security used. The form gives this rule for picking it:
| Your situation (asking about 2026) | Year to write |
|---|---|
| Your income didn't drop until 2026, or it dropped in 2025 and will be even lower in 2026 | 2026 (the “premium year”), using an estimate |
| Your income dropped in 2025 and won't be any lower in 2026 | 2025 (last year) |
| Social Security used your 2023 return (3 years back) | You can ask them to use 2024 |
Then fill in the three items for that year:
- Adjusted gross income: the amount on line 11 of Form 1040. If you're estimating, write what you expect to put on that line.
- Tax-exempt interest: the amount on line 2a of Form 1040, actual or expected.
- Filing status: check one box for your actual or expected status that year. The form notes that a change in filing status because of your event might also lower your IRMAA.
Not sure which year to use? The form says to call Social Security.
Example: You're single. Social Security used your 2024 MAGI of $150,000, so you pay $405.80 a month for Part B in 2026, plus $37.50 for Part D. You retired in March 2026 (so you check Work Stoppage and write 03/2026 in Step 1) and expect your 2026 MAGI to be about $95,000. Your income didn't drop until 2026, so you write 2026 and your estimates. If approved, you'd pay the standard $202.90 with no Part D add-on. That saves $240.40 a month, or $2,884.80 a year.
Step 3: only if next year will be even lower
Fill in Step 3 only if you expect next year's MAGI to be even lower than the year in Step 2. Write the following year (2026 in Step 2 means 2027 here), plus your estimated AGI, tax-exempt interest and filing status.
If you skip Step 3, Social Security uses your Step 2 numbers again next year. That continues until the IRS sends that year's data, or you send a filed return or a new estimate with a different amount.
Step 4: your evidence
You need proof of two things: your income for the year in Step 2, and your life-changing event. You can either:
- attach the evidence, and Social Security will mail your originals or certified copies back to you, or
- show your originals or certified copies to a Social Security employee.
Income proof: if you've filed that year's return, send your signed copy or an IRS transcript. If you gave an estimate, you must show a signed copy of the return once you file it. If you filed electronically, print the return and sign it (POMS HI 01120.030).
Event proof: Social Security must see original documents or certified copies. Examples include a certified copy of a death certificate or divorce decree, an employer's signed statement, or a pension administrator's letter. For a work stoppage or reduction with no other proof, Social Security will accept your signed statement on the form, under penalty of perjury. See the full list in our life-changing events guide.
Missing a document? Social Security can record your request as pending. But it will dismiss the request if you don't send the evidence within 30 days. If you ask for more time, it may give you 90 more days (POMS HI 01120.001).
Step 5: sign, and add your phone and address
Read the statement above the signature line before you sign. By signing, you declare under penalty of perjury that the information is true. You also accept that Social Security will check it against IRS records.
Signing alone is not a request: it has to come with proof of your event, your tax return, or other proof of the newer year's income. Add your phone number and current mailing address so Social Security can reach you.
How to submit it
- Online: go to ssa.gov/medicare/lower-irmaa, sign in, and fill out and submit the SSA-44 there, attaching scans or photos of your evidence. You'll need a Social Security online account.
- Fax or mail: send the completed form and your evidence to a local Social Security office. Because Social Security must see originals or certified copies of your event proof, a faxed copy may lead to a request for the originals.
- Appointment: sign in on that same page to schedule one. If you live outside the U.S., contact a Federal Benefits Unit.
- Phone: call 1-800-772-1213 (TTY 1-800-325-0778) and say you want to lower your IRMAA because of a life-changing event. Social Security's website lists weekday hours of 8 a.m. to 7 p.m. in most U.S. time zones.
After you file
Social Security makes a new initial determination: a fresh decision, not an appeal. An estimate gets checked against IRS data later, and you can update it as often as you need to (POMS HI 01120.065). Denied or dismissed? You still have options. See IRMAA appeal vs. SSA-44.
Want the form filled in for you? The free IRMAA and SSA-44 check tells you first whether your event qualifies and what you could save.