IRMAA Appeal with Form SSA-44: Life-Changing Events

If your income has gone down because of a qualifying event, you can ask the Social Security Administration to use a more recent (lower) year's income with Form SSA-44, Medicare Income-Related Monthly Adjustment Amount – Life-Changing Event.

The eight qualifying life-changing events

1. Marriage
2. Divorce or annulment
3. Death of your spouse
4. Work stoppage (you stopped working)
5. Work reduction (you reduced your hours)
6. Loss of income-producing property (not due to your own actions, e.g. a disaster)
7. Loss or reduction of certain kinds of pension income
8. Receipt of an employer settlement payment due to an employer's closure, bankruptcy, or reorganization

What you will need

• The completed SSA-44 stating the event, its date, and your estimated MAGI for the year you want SSA to use.
• Evidence of the event (e.g. employer letter, marriage/death certificate, divorce decree, pension notice).
• Evidence of the more recent income: a signed copy of the filed tax return, or your estimate if the year is not over yet.

If SSA approves using an estimate, it will later compare it with your actual tax return and adjust if needed. You can submit the form by mail or in person at a local Social Security office, or call SSA to request an appointment.

Official guidance: SSA — Lower your IRMAA; Form SSA-44 (PDF).