Getting Hit With a Higher Medicare Premium? How to Appeal IRMAA
Did your Medicare premiums go up even though your income has gone down? You may not have to keep paying that higher amount!
If you recently retired, lost pension income, or experienced another qualifying life-changing event, you may be able to ask Social Security to lower your Medicare premiums. The process involves Form SSA-44, which allows eligible Medicare beneficiaries to request a reduction in their Income-Related Monthly Adjustment Amount, better known as IRMAA.
At Life and Med – Medicare Resource Center, we believe understanding Medicare shouldn’t feel overwhelming. Let’s break down what IRMAA is, who may qualify for an appeal, and how to get started.
What Is IRMAA?
IRMAA stands for Income-Related Monthly Adjustment Amount. It is an additional charge that some Medicare beneficiaries pay on top of their standard Medicare premiums when their income exceeds certain limits.
IRMAA can increase the cost of:
- Medicare Part B: Helps cover doctor visits, outpatient care, and other medically necessary services.
- Medicare Part D: Helps cover prescription drug costs.
Here’s where things can get confusing: Social Security generally uses your federal income tax return from two years earlier to determine whether you owe IRMAA.
For example, your 2026 Medicare premiums are generally based on your 2024 tax return. If you earned a higher income in 2024 but retired in 2025, you could still be charged a higher premium even though your financial situation has changed.
The good news? If you experienced a qualifying life-changing event that reduced your income, you may be able to request a new calculation.
What Is Form SSA-44?
Form SSA-44 is the official Social Security form used to request a reduction in your IRMAA because of a qualifying life-changing event.
Instead of relying solely on your previous income, Social Security can review your circumstances and consider an estimate of your lower income.
However, simply earning less money does not automatically qualify you for an adjustment. Your income reduction generally must be connected to one of Social Security’s recognized life-changing events.
What Income Counts Toward IRMAA?
Social Security generally calculates IRMAA using your modified adjusted gross income (MAGI). For this purpose, MAGI is your adjusted gross income plus tax-exempt interest.
Income that may affect your IRMAA calculation includes:
- Wages and other earned income
- Pension income
- Taxable Social Security benefits
- Capital gains from selling investments or property
- Taxable Roth IRA conversions
- Required minimum distributions from retirement accounts
- Tax-exempt interest, such as certain municipal bond interest
This is important because a one-time financial transaction can increase your income for a particular year, potentially resulting in higher Medicare premiums later.
Remember, an increase or decrease in income alone does not necessarily qualify you for an SSA-44 adjustment. The circumstances behind the income change matter.
The 8 Life-Changing Events That May Qualify You for an IRMAA Appeal
Social Security recognizes eight types of life-changing events that may allow you to request an IRMAA reduction.
1. Marriage
Getting married may change your filing status and household income calculations.
2. Divorce or annulment
A divorce or annulment may change your financial circumstances and affect your income-related Medicare premiums.
3. Death of a spouse
The loss of a spouse can significantly change household income and tax filing status.
4. Work stoppage
If you or your spouse stop working, such as when you retire, your household income may decrease.
5. Work reduction
Reducing your working hours may qualify if it results in a reduction in income.
6. Loss of income-producing property
If you lose income-producing property through circumstances beyond your control, such as a natural disaster or theft, you may qualify.
7. Loss of pension income
If you lose pension income because of circumstances covered by Social Security’s rules, you may be eligible to request an adjustment.
8. Employer settlement payment
Certain employer settlement payments connected to an employer’s closure, bankruptcy, or reorganization may qualify.
Eligibility depends on the circumstances and Social Security’s requirements. A voluntary financial decision, such as choosing to withdraw less money from retirement accounts, does not automatically qualify as a life-changing event.
How to Appeal IRMAA Using Form SSA-44
If you believe your situation qualifies, here are the general steps to follow.
Step 1: Get Form SSA-44
Download the official form from the Social Security Administration website:
Get Form SSA-44 from Social Security
You can also contact Social Security or visit a local office to ask about obtaining the form.
Step 2: Identify Your Life-Changing Event
Select the event that applies to your situation and provide the date it occurred.
For example, if you retired, you will need to identify when you stopped working.
Step 3: Estimate Your Income
Form SSA-44 asks you to estimate your modified adjusted gross income for the applicable year. Depending on your circumstances, you may also need to provide an estimate for the following year.
Be as accurate as possible. Social Security may verify your estimates against your tax information.
Step 4: Gather Supporting Documents
Documentation helps Social Security verify your circumstances and determine whether you qualify.
Depending on your situation, you may need documents such as:
- A retirement letter or employer statement confirming your last day of work
- A marriage certificate or divorce decree
- A spouse’s death certificate
- A letter from your pension administrator
- Documents relating to a qualifying employer settlement
- Your most recent tax return and other records supporting your income estimate
The documentation required will depend on your specific life-changing event.
Step 5: Submit Your Request
Follow the current submission instructions provided by Social Security. You can generally submit your completed form and supporting documentation through a Social Security office.
You can contact Social Security at 1-800-772-1213 to ask about the appropriate submission method and whether an appointment is needed.
Keep copies of your form and supporting documents for your records.
What Happens After You Submit Form SSA-44?
Once Social Security receives your request, it reviews your life-changing event, income estimates, and supporting documentation.
If your request is approved, Social Security may adjust your IRMAA based on the income information it accepts. Your Part B and Part D income-related surcharges may be affected.
If you have already paid more than you owe for the applicable period, you may receive a refund or credit, depending on your circumstances.
If Social Security denies your request, review the notice carefully. It will explain the decision and provide information about your review or appeal rights.
Important: If you disagree with an IRMAA determination, you may have options beyond Form SSA-44. The correct process depends on whether you are reporting a qualifying life-changing event or challenging the determination for another reason. Follow the deadlines and instructions in your notice.
Frequently Asked Questions About IRMAA Appeals
How long does an IRMAA appeal take?
Processing times vary depending on the complexity of your situation, the documentation provided, and Social Security’s workload. Contact Social Security if you need an update on your request.
Can I submit Form SSA-44 before receiving an IRMAA notice?
You can contact Social Security to ask about submitting your request after a qualifying event. The appropriate timing and process depend on your circumstances and whether an IRMAA determination has already been issued.
Will I need to appeal every year?
Not necessarily. However, Social Security may review your income information in subsequent years, and an adjustment may not remain appropriate if your income changes. Follow any instructions Social Security provides.
What if I do not qualify under one of the eight life-changing events?
You may still have another option if you believe Social Security used incorrect information or your IRMAA determination was otherwise wrong.
For example, if your tax return was amended or the determination relied on inaccurate information, contact Social Security to ask about requesting a reconsideration or other applicable review.
Does selling a house or investments qualify me for an IRMAA appeal?
A capital gain from selling a home or investments does not, by itself, qualify as a life-changing event. The gain may increase your MAGI and affect your Medicare premiums.
If your circumstances also involve a separate qualifying life-changing event, ask Social Security whether you meet the requirements for an adjustment.
Does converting money to a Roth IRA qualify?
A Roth conversion alone generally does not qualify as a life-changing event for an SSA-44 appeal. Because a conversion may increase your taxable income, it’s important to understand the potential impact on future Medicare premiums before making the decision.
Can an IRMAA appeal lower both Part B and Part D surcharges?
Yes. If Social Security approves an adjustment that changes your IRMAA, it may affect the income-related surcharges associated with both Medicare Part B and Part D.
Let Life and Med – Medicare Resource Center Help You Navigate Medicare
Medicare premiums can be confusing, especially when your income changes after retirement. If you are facing a higher IRMAA charge, understanding your options is an important first step.
At Life and Med – Medicare Resource Center, we help people understand their Medicare options and navigate the questions that come with Medicare coverage.
Whether you are approaching retirement, reviewing your current coverage, or trying to understand a Medicare premium increase, our local team is here to help you make sense of your options.
Have questions about Medicare? Let’s talk!
Life and Med – Medicare Resource Center
216 N 3rd St, Suite B
Leesburg, FL 34748
Call or text: 352-260-0202
Your Medicare questions deserve clear answers and personal attention. Contact Life and Med today to learn more about your Medicare options.
Disclaimer: This article is for educational purposes only and is not tax, legal, or Social Security advice. IRMAA eligibility, documentation requirements, and appeal procedures depend on individual circumstances. Contact the Social Security Administration for an official determination.