SSA-44 is the Social Security form used to ask that your Medicare IRMAA surcharge be recalculated using a more recent year’s income, rather than the tax return from two years ago, after a life-changing event reduced your income.

What counts as a life-changing event for IRMAA?

Social Security recognises eight: marriage, divorce/annulment, death of your spouse, work stoppage, work reduction, loss of income-producing property, loss of pension income, employer settlement payment. A high-income year on its own does not qualify, however large.

Does a Roth conversion qualify for an IRMAA appeal?

No. A Roth conversion is not a life-changing event, however much it raised your income. The rule targets circumstances that changed your income going forward, not one-off gains. The surcharge applies for one year and then falls away.

IRMAA appeals

Form SSA-44: getting your IRMAA reduced

If your income has fallen because of a life-changing event, you do not have to wait two years for your Medicare surcharge to catch up. Form SSA-44 asks Social Security to use a more recent year instead. It is one page, it is free, and there is no deadline that stops you asking.

Checked against Form SSA-44, Medicare Income-Related Monthly Adjustment Amount — Life-Changing Event, revision 12-2025 (8 pages, OMB 0960-0784). Download it from ssa.gov, not from a third-party form site. We are not affiliated with SSA.

Do you qualify?

The form has 8 checkboxes and no “other”. Your situation has to be one of these. The wording below is the form’s own, from the instructions on page 6.

Don’t rely on SSA’s own summary

SSA's own public summary page lists only 'marriage, divorce, the death of a spouse, loss of income, and an employer settlement payment'. That is an abbreviation, not the list - the form has eight checkboxes and no 'other'.

Event	What it means
Marriage	You entered into a legal marriage.
Divorce/Annulment	Your legal marriage ended, and you will not file a joint return with your spouse for the year.
Death of Your Spouse	Your spouse died.
Work Stoppage	You or your spouse stopped working. The instructions treat stoppage and reduction as one category, but the form has a separate checkbox for each.
Work Reduction	You or your spouse reduced the hours that you work.
Loss of Income-Producing Property	Loss of income-producing property that was not at your direction — not a sale or transfer. Includes property in a Presidentially or Gubernatorially-declared disaster area, destruction of livestock or crops by natural disaster or disease, loss by arson, or loss of investment property through fraud or theft.
Loss of Pension Income	You or your spouse experienced a scheduled cessation, termination, or reorganization of an employer's pension plan.
Employer Settlement Payment	You or your spouse receive a settlement from an employer or former employer because of the employer's bankruptcy or reorganization.

What does not qualify

This is where most rejected requests come from. The rule is about circumstances that changed your income going forward — not about having had an expensive year. A one-off gain raises your premium for twelve months and then falls away on its own.

A Roth conversion, however large
Selling a property, or any capital gain you chose to realise
A one-off IRA or 401(k) withdrawal
An inheritance, or income from one
Winning a lawsuit or the lottery
Simply having had an unusually high-income year

Pension income is narrower than it looks

On the checkbox line this reads simply as loss of pension income, but the instructions narrow it to a scheduled cessation, termination or reorganization of an employer's pension plan. POMS narrows it further, to traditional defined-benefit or cash-balance plans in specified failure or termination situations. A pension that merely pays less does not qualify.

The common mistake

A large Roth conversion is the classic example. It can push you up two or three brackets, it feels like exactly the kind of thing an appeal is for — and it is not eligible. Converting is a choice you made, not an event that befell you. That is the distinction the form is drawing.

The five steps

Your name and Social Security number go at the top of page 1 — not in a numbered step, and it is your own SSN, which can differ from the number on your Medicare card. SSA estimates the whole thing takes about 45 minutes.

Type of life-changing event

Tick the event and give the date as mm/yyyy. One rule catches people out: “The life-changing event date must be in the same year or an earlier year than the tax year you ask us to use to decide your income-related premium adjustment.” So if SSA used your 2024 return for 2026, an event in 2025 lets you ask for 2025 instead.

Income that has already dropped

Not “your MAGI” as one number — the form wants adjusted gross income from line 11 of your 1040 and tax-exempt interest from line 2a entered separately, plus the filing status for that year. An estimate is allowed if the year is not finished.

Next year, if it drops again

Only if you expect the following year to be lower still — retiring mid-year is the usual case, where the first year still holds several months of salary. Leave it and SSA carries the Step 2 figure forward.

Documentation

Evidence of the event and of the income. See below — and note that SSA wants originals or certified copies, not photocopies.

Signature, phone and address

Signed under penalty of perjury. The form is explicit that signing alone is not a request — it only counts when accompanied by evidence of the event and of the more recent year’s income.

What to attach

SSA wants evidence of two separate things: that the event happened, and that your income is what you say. If you have already filed for the year in Step 2, you must provide a signed copy of that return or an IRS transcript. If you gave an estimate, you must show the signed return once you file it.

Event	What SSA accepts
Marriage	An original marriage certificate, or a certified copy of a public record of marriage.
Divorce/Annulment	A certified copy of the decree of divorce or annulment.
Death of Your Spouse	A certified copy of a death certificate, of the public record of death, or of a coroner's certificate.
Work Stoppage or Reduction	An original signed statement from your employer, copies of pay stubs, or original or certified documents showing a transfer of your business. In the absence of such proof, SSA will accept your own signed statement on the form, under penalty of perjury.
Loss of Income-Producing Property	An original insurance adjuster's statement of loss, or a letter from a State or Federal government about the uncompensated loss. Where the loss was investment fraud or theft, SSA also requires proof of conviction.
Loss of Pension Income	A letter or statement from your pension fund administrator explaining the reduction or termination.
Employer Settlement Payment	A letter from the employer stating the settlement terms of the bankruptcy court and how it affects you or your spouse.

You get your documents back

Attach the required evidence and we will mail your original documents or certified copies back to you — or show your original documents or certified copies to an SSA employee instead. This is worth knowing, because the instinct is to send photocopies and keep the originals — and photocopies are not what the form asks for.

If you stopped work and have no letter

For work stoppage or reduction specifically, if you cannot get an employer statement or pay stubs, SSA will accept your own signed statement on the form, under penalty of perjury. Retirees who left without paperwork are not stuck.

How to submit it — and when you need not

Page 5 of the form says outright that it is optional: “You do not have to complete this form in order to ask that we use your information about your modified adjusted gross income for a more recent tax year. If you prefer, you may call 1-800-772-1213 and speak to a representative to request an appointment at one of our field offices.” Lines are open 7 a.m. to 7 p.m. on business days on 1-800-772-1213 (TTY 1-800-325-0778).

If you do file it, there are three routes:

Route	Detail
Online	Sign in to a my Social Security account to fill out and submit the SSA-44 online. See ssa.gov.
Fax or post	Fax or mail the completed form and evidence to a Social Security office - find yours with the office locator. The form itself gives no central mailing address - it goes to your servicing office. Office locator.
In person	Show original documents or certified copies to an SSA employee, or call to schedule a field-office appointment.

From outside the United States, contact a Federal Benefits Unit.

Two cases where this is the wrong form

Amended return: An amended tax return is not what this form is for. SSA says to call 1-800-772-1213 instead.

Married filing separately, lived apart all year: If SSA used a year when your filing status was married filing separately but you lived apart from your spouse at all times that year, call 1-800-772-1213 to explain. The form explicitly says: do not use this form to report that change.

You may use an estimate. SSA later checks it against IRS records, and will ask for the filed return. If your estimate changes or you amend the return, you must contact SSA — otherwise there may be retroactive assessments or refunds.

Timing: no deadline, but dates still matter

No filing deadline appears on the SSA-44, and SSA's own lower-IRMAA page states none. POMS: a request may be made at any time after a life-changing event and a significant reduction in MAGI. The event may have occurred at any time in the past.

What timing does affect is which year gets adjusted. POMS: a new determination is not normally backdated to a prior premium year. The exception is where the event fell in the last three calendar months of the immediately preceding premium year AND SSA receives the request by 31 March of the current premium year. So an event in October, November or December is worth acting on before 31 March — otherwise the prior year’s surcharge stands even if the request succeeds.

Once a request is open, a different clock starts: POMS: once a request is open, failure to supply the required evidence within 30 days leads to dismissal. A 90-day extension may be granted before dismissal. This is an evidence clock, not a filing deadline.

The 60-day figure you may have read is a different process. The 60-day window people often cite is the appeal period for reconsidering an IRMAA notice - a different process. It is not an SSA-44 filing rule.

The timing rules above are SSA policy from POMS HI 01120, not text printed on the form.

Is it worth the effort?

One page of form, for a surcharge that runs a full twelve months. In 2026, being in the first IRMAA tier rather than the standard tier costs $1148.40 across the year — and the higher tiers cost multiples of that. Someone who retired last year, and whose surcharge is based on their final full salary year, is often several tiers up from where their actual income now sits.

Check the 2026 brackets to see which tier you were put in and what the one below it would have cost — that difference is what the form is worth. If you are not sure what IRMAA is or why you got it, start with how IRMAA works.