If you’re a higher-income Medicare beneficiary, you may have received a letter from Social Security telling you that your Medicare Part B and Part D premiums will be higher because of the Income-Related Monthly Adjustment Amount (IRMAA). What many people don’t know is that if your income has dropped due to a specific life-changing event — retirement, job loss, divorce, the death of a spouse — you can appeal the IRMAA determination and have it reduced or eliminated. The form for doing this is called SSA-44.
How IRMAA works
IRMAA is a surcharge added to standard Medicare Part B and Part D premiums for beneficiaries whose modified adjusted gross income (MAGI) exceeds certain thresholds. The Social Security Administration determines IRMAA based on your tax return from two years prior. For 2025 Medicare premiums, they use your 2023 tax return.
This 2-year lookback is the source of most IRMAA problems. Your income two years ago may have been much higher than your current income — particularly if you’ve retired, lost a job, or had another major life change. Without an appeal, you’d pay IRMAA based on income you no longer have.
Life-changing events that qualify for an IRMAA appeal
Social Security recognizes eight specific life-changing events that can be the basis for an IRMAA appeal:
- Marriage — usually relevant only if you’re newly receiving benefits jointly
- Divorce or annulment — reduces or eliminates a spouse’s income from the calculation
- Death of a spouse — particularly important after losing a high-earning spouse
- Work stoppage — full retirement
- Work reduction — significant reduction in work hours or income
- Loss of income-producing property — due to a natural disaster, theft, or other event outside your control
- Loss of pension income — termination, reorganization, or other reduction in employer-sponsored pension
- Employer settlement payment — one-time payment related to bankruptcy, reorganization, or similar event that inflated past income
If your income drop doesn’t fit one of these eight categories, you generally cannot appeal IRMAA. Selling stocks, choosing to reduce hours voluntarily, or simply earning less than two years ago without one of these triggers doesn’t qualify. The most common qualifying events for Medicare beneficiaries are retirement (work stoppage), loss of pension income, and death of a spouse.
Form SSA-44: the appeal form
To appeal IRMAA, you file form SSA-44, formally titled “Medicare Income-Related Monthly Adjustment Amount – Life-Changing Event.” The form is available at ssa.gov and at any local Social Security office. It’s straightforward but requires specific documentation.
What the form asks for
- Identification of the qualifying life-changing event from the list of eight
- The date of the event
- Estimated income for the year in which the event occurred (and the next year, if applicable)
- Documentation of the event
Documentation you’ll need
The required documentation varies by event:
- Retirement or work stoppage: A signed statement from your former employer confirming the retirement date, or a copy of a pension award letter, or proof of an employer separation
- Death of a spouse: A death certificate
- Divorce: A divorce decree
- Loss of pension: A letter or statement from the pension administrator documenting the loss
- Work reduction: Documentation from your employer showing the reduction in hours and pay
You’ll also need to estimate your expected income for the year. Social Security may ask for tax returns later to verify, so be reasonable and honest in your estimate.
🆓 Need help understanding your Medicare premium surcharges?
Our partner Chapter Medicare offers free Medicare guidance from licensed advisors who can help you understand your benefits and how IRMAA affects your situation.
📞 Call 615-639-1937 | 🔗 askchapter.org/money
Help is ALWAYS FREE. Chapter is compensated by insurance carriers, not by you.
How to file the appeal
- Download SSA-44 from ssa.gov or pick up a copy from a Social Security office
- Complete the form with your information, the qualifying event, and estimated income for the year
- Gather documentation for the event
- Submit by mail, fax, or in person to your local Social Security office (you can find your office at ssa.gov/locator)
- Keep copies of everything you submit
Processing typically takes 2–4 weeks. If approved, Social Security will issue a new IRMAA determination and refund any excess premiums you’ve already paid back to the start of the year the event occurred.
Timing matters
File the appeal as soon as the life-changing event happens and your income has actually changed — don’t wait until you receive the IRMAA notice. Social Security can process the appeal even before you receive an IRMAA letter, and they’ll adjust your premium going forward.
There’s no formal deadline for filing SSA-44, but the longer you wait, the longer you’ll be paying inflated premiums you can’t fully recover. Premiums paid in the past can be refunded only back to the date of the event, not earlier.
What happens if your appeal is denied
If your initial SSA-44 appeal is denied, you have the right to a formal reconsideration. You can request reconsideration within 60 days of the denial notice by submitting form SSA-561-U2 (Request for Reconsideration). If reconsideration is also denied, you can appeal further to an Administrative Law Judge.
Most legitimate SSA-44 appeals based on documented qualifying events succeed. Denials usually result from missing documentation, an event that doesn’t meet the technical criteria, or income estimates that seem inconsistent with the documented event.
Special considerations for newly retired Medicare beneficiaries
Retirement at 65 or 66 is often the most common qualifying event for IRMAA appeals. Many people retire with much lower income than they had during their peak earning years. The 2-year lookback means your first Medicare premium calculation uses your income while you were still working — often the highest income year of your life.
File SSA-44 in your first year of retirement to avoid paying inflated IRMAA based on pre-retirement income. The savings can be substantial — in 2025, the highest IRMAA bracket adds over $7,000 per year per person in premium surcharges. Even modest IRMAA reductions can save thousands annually.
Married filing jointly considerations
If you and your spouse file taxes jointly, your IRMAA is based on the joint return. If only one spouse has a qualifying life-changing event (a spouse’s retirement, for example), the SSA-44 appeal can still reduce the IRMAA for both of you, since you’re filing one joint return.
If a spouse dies, the surviving spouse files SSA-44 based on the death and adjusts going forward. The income calculation changes from a joint MAGI to the survivor’s individual income, often substantially reducing IRMAA.
Bottom line
If your income has dropped due to a qualifying life-changing event — retirement, divorce, death of a spouse, loss of pension — you can appeal your IRMAA premium surcharge using form SSA-44. The appeal is free, generally straightforward with proper documentation, and can save thousands of dollars annually. File it as soon as the event occurs rather than waiting for a notice. Most legitimate appeals succeed; the biggest mistake is not filing one when you qualify.
🆓 Have questions about your Medicare premiums or benefits?
Our partner Chapter Medicare offers free, unbiased guidance from licensed advisors. They can help you understand your Medicare costs and find ways to reduce them.
📞 Call 615-639-1937 | 🔗 askchapter.org/money
ALWAYS FREE. No obligation.
Disclosure: We may receive a referral from Chapter if you choose to use their service. Chapter is a licensed health insurance agency and is not affiliated with or endorsed by Medicare or any government agency.
Further Reading
- IRMAA: How Income Affects Medicare Premiums
- Medicare Costs and Premiums
- Medicare Savings Programs
- How to Reduce Taxes on Social Security Benefits
- Tax-Efficient Withdrawal Order in Retirement
- Roth Conversions Explained
This article is for general educational purposes only and does not constitute insurance or financial advice. Visit medicare.gov or contact 1-800-MEDICARE, or consult a licensed advisor for guidance specific to your situation.