How to Fill Out Form SSA-44, Step by Step
The five steps of the IRMAA life-changing event form, which figures go where, the evidence each event needs, and how to send it so Social Security actually processes it.
Updated 30 Sept 2026
Form SSA-44 has five steps. Step 1 names the life-changing event and its date. Step 2 reports a year whose income has already dropped, using the AGI and tax-exempt interest from the filed tax return. Step 3 is for an expected drop, using your own estimate. Step 4 lists the evidence, and Step 5 is the signature. Send it with the evidence by mail or fax to a Social Security office, or bring it to an appointment.
What does this mean for you? Work out your own number: Medicare IRMAA calculator
This guide walks through the form itself. Whether your situation qualifies at all — which of the life-changing events count, and why a smaller portfolio or a one-off Roth conversion doesn’t — is covered in Form SSA-44: getting an IRMAA surcharge reduced.
Before you start
Have these in front of you:
- The IRMAA letter from Social Security, if you have one. It names the tax year and income it used. You don’t have to wait for it to file, but it tells you what you are trying to replace.
- The tax return for the year whose income has already dropped, if you have filed it.
- A reasonable estimate of this year’s or next year’s income, if the drop hasn’t reached a filed return yet.
- The evidence for your event (see Step 4).
Step 1: Type of life-changing event
Check the event and enter the month and year it happened. The choices are marriage, divorce/annulment, death of your spouse, work stoppage, work reduction, loss of income-producing property, loss of pension income, and employer settlement payment.
Retirement is work stoppage. Going part-time, or a spouse cutting hours, is work reduction. The event must fall in the tax year you ask Social Security to use, or earlier.
Step 2: Reduction in income that has already happened
Use Step 2 when a tax return you have already filed shows the lower income. Enter:
- the tax year of that return,
- your adjusted gross income and your tax-exempt interest, copied exactly from the filed Form 1040 — together they make up the modified adjusted gross income (MAGI) that IRMAA uses,
- your filing status on that return.
Don’t recalculate or adjust anything here. Social Security checks these figures against the IRS.
Step 3: Reduction you expect
Use Step 3 when the drop hasn’t reached a filed return yet — typically the year you retire, or the year after. Answer whether your MAGI will be lower, then enter your estimated adjusted gross income, tax-exempt interest and filing status for that year. If your income isn’t going down (a marriage that didn’t change it, for example), answer no and move on.
Estimate honestly. Once the IRS has the real return for that year, Social Security compares it with your estimate and corrects the premium, up or down, if the actual figure lands in a different bracket.
Step 4: Documentation
Attach evidence of the event:
| Event | Evidence Social Security expects |
|---|---|
| Marriage | Marriage certificate |
| Divorce or annulment | Final divorce or annulment decree |
| Death of spouse | Death certificate |
| Work stoppage or reduction | Letter from the employer, or your own signed statement about when work stopped or was reduced |
| Loss of income-producing property | Insurance claim, police or fire report, or other proof of the loss |
| Loss of pension income | Letter from the pension plan about the reduction or termination |
| Employer settlement payment | The settlement agreement or a letter describing it |
Social Security returns original documents, but send copies where it accepts them, or keep a copy of anything you send, especially certificates that are hard to replace.
Step 5: Signature
Sign and date the form and add your phone number and mailing address. The form is signed under penalty of perjury, so the facts in Step 1 must be true even though the Step 3 figures are estimates. Adding a copy of the relevant tax return, when you have one, speeds up processing.
Sending it
Mail or fax the form and evidence to your local Social Security office, found with the office locator on ssa.gov, or bring them to an appointment. Keep a copy of everything and note the date you sent it.
If it’s approved, the new premium applies back to January of the year in question, and any surcharge already deducted is refunded or credited. The standard time to file is when the IRMAA letter arrives, usually in November or December for the following year, but you can file any time during the year.
What it can be worth
A married couple, both on Medicare, retired in 2025. Their 2024 joint MAGI was $290,000, so for 2026 each of them pays an extra $202.90 a month for Part B and $37.50 for Part D. That is $5,769.60 a year for the two of them. Their 2025 MAGI, after retirement, is about $150,000 — below the $218,000 first threshold for joint filers.
Filing SSA-44 with work stoppage as the event and 2025 income removes the whole surcharge for 2026. To check your own numbers, run both figures through the IRMAA calculator.
If it’s refused
A refusal of an SSA-44 request is a new determination that can be appealed. That goes through a request for reconsideration (Form SSA-561), a separate process from the SSA-44 request itself.
Sources
- Form SSA-44: Medicare Income-Related Monthly Adjustment Amount — Life-Changing Event, Social Security Administration
- Lower your IRMAA, Social Security Administration
- 2026 Medicare Parts A & B Premiums and Deductibles, Centers for Medicare & Medicaid Services