Form SSA-44 Instructions

Did you receive an IRMAA determination letter?  If you have recently experienced a life-changing event, you may be able to use Form SSA-44, also known as Medicare Income-Related Monthly Adjustment Amount – Life Changing Event.

The SSA-44 allows the Social Security Administration (SSA) to make the necessary corrections to lower or eliminate your IRMAA.   

In this article, we’ll walk you step by step through:

  • How the SSA-44 works 
  • When you might consider using the SSA-44 
  • Key information you can find on the SSA-44 
  • How to fill out the SSA-44 
  • What documentation you may need to send with your filled out SSA-44 
  • How to submit the SSA-44 for consideration
  • Resources that may help you walk through the SSA-44 form

We’ll start by walking through how to complete the form, step by step. But before we do, I’ve created a low-cost, convenient course that goes through everything you’re about to read below.

If you don’t want to read all of this information, please visit my IRMAA course page to decide if it’s right for you. If not, please feel free to read this article and watch the YouTube tutorial, free of charge!

How to fill out the SSA-44

There are five steps to filling out the SSA-44.  We will break down each step of the SSA-44 so you can clearly understand what is required.   

Step One: Type of Life-Changing Event

This is the type of life-changing event that happened in your life, and when it occurred.  The eight types of life-changing events that SSA will consider in their IRMAA determination are: 

  • Marriage: You entered into a legal marriage 
  • Divorce/Annulment: Your legal marriage ended, and you will not file a joint return for the year. 
  • Death of your spouse: Your spouse died. 
  • Work Stoppage: You or your spouse stopped working. 
  • Work Reduction: You or your spouse reduced your work hours 
  • Loss of Income-Producing Property: You or your spouse experienced a loss of income-producing property not under your control.  
    • Examples include disaster, losing property due to arson, fraud or theft 
  • Loss of Pension Income: You or your spouse experienced some sort of disruption (cessation, termination, or reorganization) of an employer’s pension plan. 
  • Employer Settlement Payment: You or your spouse receive a settlement from your employer/former employer because of bankruptcy. 
form ssa-44, step 1: type of life-changing event
SSA-44 Step 1: Type of Life-Changing Event

SSA 44 Step One asks what type of life-changing event occurred and when it happened. This step also asks for the date that the event took place, because it must be in the same tax year or an earlier tax year than the one you ask SSA to consider.  

Let’s imagine that the SSA calculated the 2024 IRMAA with 2022 tax information. However, you got married in 2023. In that case, you could use the 2023 information instead. 

Step Two: Reduction in Income

This is where you fill in the modified adjusted gross income (MAGI) for the given tax year.  For most people, the 2022 tax data would have gone into the 2024 IRMAA calculation.

The SSA calculates your MAGI using two lines on your tax return: 

  • Adjusted Gross Income: Line 7 of Form 1040 or Form 1040-SR of your tax return
  • Tax-Exempt Interest: Line 2A of Form 1040 from your tax return
    • An example of tax-exempt interest would be municipal bond interest. 
step 2: Reduction in income
SSA-44 Step 2: Reduction in Income

SSA 44 Step Two asks for your tax information and filing status for the tax year in question.

You’ll simply fill in this information, as well as the tax filing status for that year. 

Be sure that you only report what was already reported on your tax return. Don’t change anything here. That will be in Step 3. 

Step Three: Modified Adjusted Gross Income

This is where you estimate your income to be based upon your life-changing event. This step has three parts: 

  1. Will your MAGI be lower next year than the year in Step 2?
    • If the answer is ‘Yes,’ then you’ll complete the rest of Step 3. 
    • If the answer is ‘No,’ then you’ll skip to Step 4
    • Note:  It doesn’t always have to go down.  For example, if you got married, but your income didn’t change, then you would answer ‘No’ and move to Step 4.  
  2. Fill in the tax year, estimated AGI, and estimated tax-exempt interest. If you work with a financial advisor or a tax professional, then they can run a tax projection for you based upon your life-changing event.  If not, then you might have to do this yourself.  
  3. Expected tax filing status.  If your tax filing status hasn’t changed, then this should be straightforward.  However, if you got married or divorced, or became a widow(er), then this might be a little difficult.  Below is a little background. 


According to the IRS, your filing status is based upon your marital status as of December 31 of the year on your tax return.    

Marriage:  If you got married before December 31, then you can file as married (either jointly or separately). If you get married on January 1 of the next year, then you would file as single (unless you are filing jointly with a deceased spouse for the year in question). 

Divorce:  If your divorce decree is finalized before the end of the year, then you would file as Single. If your divorce becomes effective on January 1 or later, then you would file as married (either separately or jointly). 

Deceased Spouse:  If your spouse died, then you can file a joint tax return for the year in which they died.  After that, you’ll either file as single (if you didn’t remarry), married (if you did remarry), or qualifying widow(er) (if you have a dependent child). If you are able to file as a qualifying widow(er), that privilege exists for the two tax years after your spouse’s death. 

The IRS has a page where you can determine your filing status, which takes about 5-10 minutes to walk through. Check it out in this Youtube video.

form ssa 44, step 3, modified adjusted gross income
SSA-44 Step 3: Modified Adjusted Gross Income

SSA 44 Step Three asks for your expected MAGI for the year following the year of your life-changing event.

Step Four: Documentation

In this step, you’ll collect the required documents (or certified copies of those documents), depending on your life-changing event.  You can find this list on page 8 of the SSA-44. 

Hint:  If you only have one copy of the document, you may want to get a copy so you can keep the original.  

In the case of a work stoppage or reduction, you simply need to sign a statement (under penalty of perjury) that you’ve partially or completely stopped working, or that you took a job with less compensation.  

While the SSA returns all submitted documents, you should keep a copy for your own records. 

step 4: documentation
SSA-44 Step 4: Documentation

SSA 44 Step Four asks for supporting documentation.

Step Five: Signature

You’ll sign the document under penalty of perjury.  In other words, if you attempt to defraud the government, you can face penalties. So this form should only be completed if you’re sincere.   

You’ll also want to provide a copy of your tax return, which will help speed up the determination process. 

form ssa 44, step 5: signature
SSA-44 Step 5: Signature

SSA 44 Step Five asks for your signature (sworn under oath).

Please note:  If there are two spouses on Medicare, you’ll probably each receive an IRMAA determination letter.  If that’s the case, then you’ll need to do this for each spouse.   

How Form SSA-44 works

IRMAA (also known as Income-Related Monthly Adjustment Amount) is an increase in Medicare premiums based on income.  In other words, the United States government uses your tax returns to determine whether you should pay more for Medicare than the standard premium.  If IRMAA applies, you pay an additional surcharge for both Medicare Part B and Part D.

If your income tax returns reflect a higher modified adjusted gross income (MAGI), you’ll receive a letter known as an “Initial Determination Notice.” The Social Security Administration usually sends these notices in advance of the following year.  

For example, 2024’s IRMAA letters were sent towards the end of 2023.  However, those determinations were mostly based upon 2022 tax returns.

The reason for this is simply because 2023 hadn’t even finished.  Because of this process, IRMAA determinations are (at best) based upon tax information that is two years old.   

And a lot could have changed in your life between 2022 and 2024 that might have lowered your income. For example, many people retire and their income naturally goes down in retirement.  

In recognition of this, the SSA defines specific events that may have impacted your income as ‘life-changing events.’   

Key information you can find on SSA-44

Virtually everything you need to successfully complete the SSA-44 is found on the SSA-44 itself. However, it’s worth pointing out some of the useful things you can find on the form: 

Part B premium tables

Here are the tables for Part B premiums:  

2024 IRMAA rates for Medicare Part B for single or married filing jointly
2024 Medicare Part B IRMAA rates

Below is a separate table for married taxpayers filing separate returns.

2024 Medicare Part B IRMAA rates for married couples filing separate returns
2024 Medicare Part B IRMAA Surcharges for married couples filing separate returns

Part D premium tables

And here are the surcharges for Medicare Part D:

2024 Medicare Part D IRMAA rates for single and married taxpayers filing joint tax returns
2024 IRMAA Surcharges for Medicare Part D
2024 Medicare part d IRMAA rates for MFS
2024 Medicare Part D IRMAA surcharges for married couples filing separate returns

From here, you can figure out not only what SSA is billing you, but what you should be paying based upon your life-changing event.   

For example, if your 2022 MAGI was $120,000 and you filed a tax return as a single taxpayer, then you would fall under the first IRMAA tier.  

This means that you would be expected to pay an additional $69.90 in Part B premiums per month. Your Part D premiums would go up by $12.90 per month.

Let’s say you got married in 2023, but your income wasn’t expected to increase. This is a change in your tax filing status. That means you could be reconsidered as if you were married, filing jointly (which you probably would end up doing when you file your 2023 tax return).  

In that case, your $120,000 MAGI would be under the IRMAA threshold and you wouldn’t pay any additional premiums. 

In other words, you can use this table to have a pretty good estimate of where you’ll end up before you start filling out the paperwork.  

Video walkthrough

When you might consider using SSA-44

If a life-changing event has impacted your income, then you would use the SSA-44 to request a reconsideration of the new facts for a new IRMAA determination.  

Submitting an SSA-44 is not an appeal—it’s actually much simpler than the appeals process.  An SSA-44 asks the SSA to consider new income-related facts as if they were part of the initial determination.   

Frequently asked questions about SSA-44

Can I submit SSA-44 online?

Unfortunately, the Social Security Administration cannot accept electronic versions of this form. You must bring your completed SSA-44 to your local Social Security office for consideration.

Is an IRMAA update retroactive?

Yes. If the Social Security Administration processes your request for consideration, then your new Part B and Part D premiums will be retroactively applied to the beginning of the year.

Do I need to pay someone to complete Form SSA-44 on my behalf?

No. You can complete this form your self, or with the assistance of an SSA representative. There is no reason you should feel compelled to pay someone to complete this form for you.

How do I submit Form SSA 44 for consideration?

You can call your local Social Security office for instructions on how to submit the SSA-44 and supporting documentation. To find the closest Social Security office to you, go to the Social Security Office Locator and type in your zip code. 

Do you need assistance completing Form SSA 44?

After helping numerous clients and readers to complete this form, I decided to create a course for people who need a little bit of extra help understanding their form.

This low-cost course was designed to be a user-friendly and affordable option for people who want to make sure they complete the form correctly, but are frustrated by long waits and customer service at the Social Security Administration.

For more information, please check out my IRMAA course page.

Where can I find a copy of SSA-44?

You can go to the SSA website to save a copy of this form for your records or to complete. You may also obtain a copy from your local SSA office.

For your convenience, we’ve attached the latest version of this form to the bottom of this article. 

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  1. Excellent walk-through, having done this three times, it is hard to find good info on this subject.

    A couple of things I would add:
    1. Step Two applies to the year you had or have the life-changing event, so it can be the current year. Step Three then becomes the next year (future). If you are using the current year for Step Two, you will be estimating your MAGI for both Step Two and Step Three.

    This may be an improvement over the prior need to file SSA-44 two years in a row. Recently filed this for 2023 and 2024. Received the reduction back to Jan. 2023. We’ll see if the November 2023 letter has the IRMAA calculation correct from this SSA-44, or if it still looks back to 2022 when income was higher.

    2. If you are retiring, get a statement on letterhead from your HR office of your retired status before you leave work and file it away in case you need it for your LCE in a future year.

    3. If you are married, make sure to bring a copy of your marriage certificate to the SSA office. They will need proof that the LCE of one or the other spouse should be applied.

    Thanks again, and one typo in Step Two: the SSA-44 form screenshot must be from an older version because if references AGI being on Line 7 of the 1040 and you have that in the text also. AGI is on Line 11 for 1040s from 2020 on (so far; it keeps moving around).

  2. Richard B. Davis says:

    I’m wondering why my notice from Social Security Administration with an income between $183,000.01 and $499,999.99 shows part B IRMAA charges of $384.30 while the form SSA-44 has that extra charge as $362.60. Also the charge for part D on the notice is $74.20 and on SSA-44 has the charge as $70.00. I’m filing single as my wife passed 3+ years ago which should make no difference now. The website information is said to be accurate so please explain the difference.

    1. Forrest Baumhover says:


      Thank you for your question. There’s a simple explanation for this. As of today, the SSA has not updated the Form SSA-44 to reflect the new IRMAA charges. The form version on the SSA website is from 12/2022. The SSA should be releasing a new version of the form relatively soon, which should reflect the updated rates. Once that’s posted, I’ll update this article accordingly.

      However, the rates in your notice are correct, according to the Medicare website:

  3. B.L. Steinhagen says:

    My wife inherited 9 shares of no par value common stock from her mother. The company merged with another and the new merged company forced the sale back to them. Hence the sale was out of our control as we had no plans to sell. Received notice that IRMAA was going to raise our Medicare premiums from $174 to $559 per month. Does a force stock sale qualify as a life changing i.e. Loss of property as the shares provide annual income? Should I ask for a new determination based on the forced sale? Have you ever had this before?

    1. Forrest Baumhover says:

      Theoretically, it may be possible, but I see a couple of hurdles that you’d have to jump through.

      1. This has to be loss of income-generating property. If you can demonstrate that your future income will be significantly lower because of this, then you might have a chance.

      But it’s still a long shot, because there are several statements in the SSA operating procedures (known as POMS) that don’t directly address your situation, but don’t really help you, either.

      2. From the SSA POMS HI 01120.035 Life Changing Event (LCE) – Loss of Income-Producing Property (

      The loss of income-producing property must not be caused by the beneficiary’s direction. The loss must be caused by circumstances beyond the beneficiary’s control. A loss due to donation, gift, sale or transfer of income-producing property is not considered a loss beyond the beneficiary’s control and does not qualify for a new initial determination using a more recent tax year. Ordinary risk of loss taken at the time of investment in income-producing property is considered at the beneficiary’s direction. Examples of circumstances beyond a beneficiary’s control are losses caused by:

      Natural disasters (such as flood, hurricane, tornado, fire, earthquake, volcano eruption)
      Disease (affecting crops, livestock or other animals)
      Buy-out of the property by a government under Eminent Domain
      Theft (including the taking of money or property by blackmail, burglary, embezzlement, extortion, larceny, robbery, fraud, investment fraud or other criminal activity)

      NOTE: Loss of dividend income does not qualify as a loss of income from income producing property unless the loss is due to criminal theft. See HI 01120.005D.

      3. POMS HI 0112.005D ( states:

      Some examples of one-time income that cause an increase and are non-qualifying events (NQEs) include:

      Capital gains from the sale of property
      Lottery winnings;
      Casino winnings;
      Conversion of an IRA; or
      Cashing bonds.

      So the problem that you’re facing is that there doesn’t appear to be clear guidance (publicly available) that supports your case. Which will make it more difficult for someone to process a new determination to your satisfaction. But your best bet may be to try and convince someone that your situation is more like the eminent domain situation, rather than a voluntary sale.

      I wish you the best of luck!

  4. Anonymous says:

    Crazy you can’t fax or email a copy in!