If Social Security says your Medicare premium is going up because of your income, and your income has since dropped because you retired, you can ask them to use your current income instead. The form is SSA-44, and it works — but only for a specific list of life-changing events.
This is the single most valuable Medicare form most retirees have never heard of. IRMAA is calculated from a tax return two years old, so the year you stop working is exactly the year you get billed as though you are still earning.
What is IRMAA?
IRMAA stands for income-related monthly adjustment amount. If your modified adjusted gross income is above a threshold, you pay a surcharge on top of the standard Part B premium and an additional amount on Part D.
Two features drive most of the complaints:
- It uses a two-year lookback. Your 2026 premium is based on the tax return you filed for 2024. Retire in 2025 and your 2026 premium still reflects your working income.
- It is a cliff, not a slope. Cross a threshold by one dollar and you pay the full bracket surcharge. There is no phase-in.
You will learn about it from an "Initial IRMAA Determination Notice" from Social Security, usually in the fall for the following year. The thresholds are adjusted annually — get the current year’s brackets from your notice or from medicare.gov, not from an older article.
The eight life-changing events
SSA-44 only works for these. If your situation is not on this list, the form will be denied no matter how sympathetic the facts.
- Marriage
- Divorce or annulment
- Death of a spouse
- You or your spouse stopped working (retirement)
- You or your spouse reduced work hours
- Loss of income-producing property, due to a disaster or other event beyond your control
- Loss of pension income
- Employer settlement payment due to employer bankruptcy or reorganization
Numbers 4 and 5 cover the overwhelming majority of successful filings.
What is not on the list, and this is where people get turned down:
- A one-time capital gain from selling a house or stock
- A Roth IRA conversion
- Taking a large IRA distribution
- Receiving an inheritance
- Exercising stock options
Those raise your income without being life-changing events, so IRMAA applies and SSA-44 will not fix it. The only remedy there is that the surcharge is temporary — it goes away two years later when the spike drops out of the lookback.
How to file Form SSA-44
- Download SSA-44, "Medicare Income-Related Monthly Adjustment Amount – Life-Changing Event," from ssa.gov/forms.
- Step 1: pick the event and the date it happened. Be precise. The date determines which year SSA can use.
- Step 2: give the reduced income year and the amount. You can use the most recent tax year or an estimate of the current year. Estimating the current year is the whole point when you retired mid-year — do not wait until you have a filed return.
- Step 3: if the following year will be lower still, report that too. A person who retires in September has a partial year of wages; the next full year is often much lower.
- Step 4: attach evidence. A signed statement from the employer, a retirement letter, a pension award letter, a death certificate, a divorce decree, a marriage certificate. A tax return or transcript if you are using a filed year.
- Sign it and submit it to your local SSA office by mail, fax, or in person. Keep a copy and a delivery receipt.
- Follow up in about a month. These are processed by hand and they do get lost. Any premium already overpaid is refunded once the determination changes.
SSA-44 vs. a reconsideration request
They solve different problems and are filed differently.
| SSA-44 | Reconsideration (Form SSA-561) | |
|---|---|---|
| Use when | Income dropped because of a life-changing event | SSA used the wrong data, or the IRS data is wrong or amended |
| Asks for | Use of a newer, lower income year | Correction of the determination itself |
| Evidence | Proof of the event plus income figures | Corrected tax return, IRS transcript, or proof of the correct figure |
If you amended your return, or SSA used a year you did not expect, reconsideration is the right form. If you simply retired, SSA-44 is.
Do this every year until the lookback catches up
The determination is annual. If you retired in 2025, you may need to file SSA-44 for the 2026 premium year and again for 2027, until the tax year SSA uses is a year that already reflects retirement income. People file once, get relief, and are surprised the following January when the surcharge returns.
What else can lower a Medicare premium
- Medicare Savings Programs. If income is low, a state program may pay the Part B premium outright. Different test, different agency — see Medicare Savings Programs income limits.
- Part B giveback plans. Certain Medicare Advantage plans reduce the Part B premium as a plan benefit. That is a plan feature, not an SSA action — see how Part B giveback works.
- Extra Help for Part D costs, which also eliminates the Part D late enrollment penalty. See Medicare Extra Help.
FAQ
How much can SSA-44 save me?
It depends entirely on how many brackets you drop. Moving from the first surcharge tier to the standard premium is worth roughly a thousand dollars a year across Part B and Part D for one person, and double that for a couple who both file.
Can I file SSA-44 before I get the IRMAA notice?
You can file as soon as the life-changing event has occurred. Filing right after the notice arrives is more common, but earlier is fine if the event already happened.
Is there a deadline?
There is no hard statutory deadline for SSA-44, but relief generally applies going forward and to the premium year in question. File promptly; do not sit on it for a year.
Does selling my house count?
No. A capital gain is not a life-changing event. The surcharge will expire on its own two years later.
Does my spouse need to file separately?
If you file jointly and both are on Medicare, each person’s premium is adjusted, and SSA generally wants a form for each beneficiary. Ask when you submit.
What if SSA-44 is denied?
You can request reconsideration of that denial, and beyond that there is an administrative law judge hearing. State clearly which of the eight events applies and attach better evidence.
As of August 2026. IRMAA brackets change annually and are set by CMS; the eight qualifying life-changing events are set in SSA regulation. Confirm your own figures with SSA. Forms: ssa.gov/forms. Premium information: medicare.gov.