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- Click ‘Get Form’ to open it in the editor.
- Begin by selecting the type of life-changing event from the list provided. Check one box and enter the date of the event (mm/dd/yyyy).
- In Step 2, fill in the tax year when your income was reduced, along with your adjusted gross income (AGI) and tax-exempt interest income. Choose your tax filing status for that year.
- If you expect your modified adjusted gross income to be lower next year, complete Step 3 with estimated figures for the next tax year, including AGI and expected filing status.
- In Step 4, provide documentation supporting your MAGI and life-changing event. You can attach evidence or present it to an SSA employee.
- Finally, read the information carefully before signing in Step 5. Fill in your phone number and current mailing address for contact purposes.
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| Versions | Form popularity | Fillable & printable |
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| 2025 | 4.9 Satisfied (24 Votes) | |
| 2024 | 4.9 Satisfied (42 Votes) | |
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| 2022 | 4.8 Satisfied (37 Votes) | |
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| 2011 | 4.4 Satisfied (492 Votes) |
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When should I file SSA-44?
You should fill out Form SSA-44 if you experience any life-changing event that reduces your income. Life-changing events that qualify are marriage, divorce, death of a spouse, work stoppage, work reduction, loss of income-producing property, loss of pension income and employer settlement payment.
Can I submit SSA-44 online?
SSA does not provide SSA-44 forms online at this time, so you will need to print out the form from the SSA website. You will then need to mail the form to your local SSA office, along with any other information they request as outlined in step four above.
How do I request an Irmaa adjustment?
To request a new initial determination, submit a Medicare IRMAA Life-Changing Event form or schedule an appointment with Social Security. You will need to provide documentation of either your correct income or of the life-changing event that caused your income to decrease.
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People also ask
What are the Irmaa brackets for Medicare?
C. IRMAA tables of Medicare Part B premium year for three previous years IRMAA Table2019More than $160,000 but less than $500,000 More than $500,000$433.40 $460.50Married filing jointlyMore than $170,000 but less than or equal to $214,000$189.60More than $214,000 but less than or equal to $267,000$270.909 more rows • Dec 6, 2021
Can I submit SSA-44 online?
SSA does not provide SSA-44 forms online at this time, so you will need to print out the form from the SSA website. You will then need to mail the form to your local SSA office, along with any other information they request as outlined in step four above.
What are the Irmaa brackets for 2022?
How much are Part B IRMAA premiums? Table 1. Part B \u2013 2022 IRMAAIndividualJointMonthly Premium$91,000 or less$182,000 or less$170.10> $91,000 \u2013 $114,000> $182,000 \u2013 $228,000$238.10> $114,000 \u2013 $142,000> $228,000 -$284,000$340.203 more rows • Aug 23, 2022
At what income does Irmaa kick in?
Who Pays IRMAA? As noted above, only individuals who earn more than $88,000 and married couples filing jointly who earn more than $176,000 are required to pay IRMAA.
Can I submit SSA-44 online?
SSA does not provide SSA-44 forms online at this time, so you will need to print out the form from the SSA website. You will then need to mail the form to your local SSA office, along with any other information they request as outlined in step four above.