The IRMAA appeal form is Form SSA-44, titled “Medicare Income-Related Monthly Adjustment Amount — Life-Changing Event,” and it is free to download at ssa.gov/forms and free to file. It asks Social Security to recalculate your Medicare surcharge using your current, lower income — instead of the two-year-old tax return that set it — when a qualifying life-changing event, most commonly retirement, is the reason your income dropped.
Revised: 7/24/26
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It walks through Form SSA-44 step by step — the eight qualifying life events, the evidence that supports each one, and a worked example.
The guide is on its way — allow up to 10 minutes. If it hasn’t arrived by then, peek in your spam folder, and if it’s there, click “Not spam,” so the next person’s guide arrives where it belongs. You’re all set.
The long answer
The form runs a few pages and asks for four things: your event and its date, this year’s income estimate (and next year’s, if it will drop further), your evidence, and your signature. A successful filing lowers both surcharges — IRMAA, the Income-Related Monthly Adjustment Amount, attaches to Part B and Part D alike.
Eight events qualify: retirement (the form’s term is work stoppage), a real cut in work hours, marriage, divorce or annulment, the death of a spouse, a pension that stopped or shrank, income-producing property lost to events beyond your control, and an employer settlement tied to a bankruptcy or reorganization. A one-time spike — a large Roth conversion, a business sale — does not qualify; it was real income that year, and it rolls out of the formula after one cycle.
Attach proof of the event — an employer letter stating your last day, a death certificate, a divorce decree — plus documents behind your estimate, such as pension award letters and last year’s 1099s, then file with your local Social Security office, by certified mail, or by phone at 1-800-772-1213. If the tax data Social Security used was wrong or outdated, you don’t need this form — ask Social Security to redo the determination with the corrected IRS records.
Printed from JasonKnowsMedicare.com — “The IRMAA Appeal Form (SSA-44): What It Is and How It Works”. The free IRMAA Appeal Kit is available at tally.so/r/XxvNNO · Questions: (850) 810-1000
This page is educational information, not personal financial, tax, or legal advice. For decisions about your own situation, talk with a qualified professional.