If IRMAA, an income surcharge, has pushed your Medicare premium up and retirement or a spouse's death has since cut your income, you can ask Social Security to lower or remove it. Maybe the higher amount showed up on a notice from Social Security or on a bank statement. Let's walk through how to appeal your Medicare IRMAA, step by step, including which events count and which ones don't.

In This Guide

Why Your Premium Is Higher: What IRMAA Is

So the short version first. IRMAA stands for Income-Related Monthly Adjustment Amount, and it's an extra charge Social Security tacks onto your Medicare Part B and, if you have drug coverage, your Part D premium. It kicks in when your income is above a set threshold for the year. In 2026, the standard Medicare Part B premium is $202.90 a month, and IRMAA is a surcharge added on top of it for people whose income is above the threshold.

Here's the piece that catches almost everyone off guard. Social Security doesn't look at what you earn now. It uses the income (technically your modified adjusted gross income, or MAGI) from your tax return two years back. For 2026, that means your 2024 return, or your 2023 return if 2024 wasn't available. For 2026, the surcharge starts once that 2024 MAGI tops $109,000 if you filed single, or $218,000 if you filed jointly.

You can probably already see the problem. Plenty of people had a big income year in 2024, then retired or lost a spouse, and now they're being charged based on money that isn't coming in anymore. When one of Social Security's listed life-changing events caused that drop, this is the situation the SSA-44 process exists for. A one-time gain is different. If 2024 ran high because you sold a house or a rental property, or did a large Roth conversion, that alone isn't a qualifying event: the form expressly excludes the sale or transfer of property, and a conversion isn't on the list.

Before You Appeal Your Medicare IRMAA: See Whether SSA-44 Fits

Good news on this one: you're not stuck with the surcharge. If a life-changing event has reduced your household income, you can ask Social Security to lower the extra amount you pay for Part B and Part D by basing it on a more recent tax year.

The usual tool is Form SSA-44, officially the "Medicare Income-Related Monthly Adjustment Amount (Life-Changing Event)" form. You tell Social Security what happened and what your income looks like now, attach proof, and ask it to use the newer year. But you don't have to use the form at all. Form SSA-44's own instructions say you can call Social Security at 1-800-772-1213 instead and ask for an appointment at a field office to request a lower IRMAA.

One thing not to do: if you don't owe IRMAA in the first place, the form says not to fill it out, even if you had a life-changing event.

Which Life-Changing Events Qualify

Not just any drop in income counts. Social Security's SSA-44 form lists the specific events that qualify, and several come with conditions attached:

  • You got married.
  • Your marriage ended in divorce or annulment, and you won't file a joint tax return with your spouse for the year.
  • Your spouse died.
  • You or your spouse stopped working or reduced your work hours (retirement counts here).
  • You or your spouse lost income-producing property in a way that wasn't your choice. The form gives examples: real property lost in a Presidentially or Gubernatorially declared disaster area, livestock or crops destroyed by natural disaster or disease, property lost to arson, or investment property lost to fraud or theft. Selling or transferring property doesn't count.
  • You lost pension income because an employer's pension plan was terminated, reorganized, or ended on a schedule.
  • You received a settlement payment from an employer because of that employer's bankruptcy or reorganization.

If your income dropped for a reason that isn't on that list, SSA-44 won't lower your IRMAA. Retirement and the loss of a spouse, though, are both squarely on it.

Timing matters too, and it's an easy rule to trip on. For an IRMAA life-changing-event request, the event has to have happened in the same year as, or an earlier year than, the tax year you're asking Social Security to use. So if Social Security used your 2024 return to set your 2026 IRMAA, you can ask it to use your 2025 income instead if an event in 2025 or earlier reduced that 2025 income. There's one exception: if Social Security used your income from three years before the premium year, you can ask it to use your income from two years before instead.

How to File Form SSA-44

The form itself is short. The part that matters is getting the event, the date and your income right, so let's break the filing into plain steps.

1
Step 1

Get the form, or skip it

Social Security's request to lower IRMAA page links to Form SSA-44. If you'd rather talk it through, call 1-800-772-1213 (Monday through Friday, 8 a.m. to 7 p.m.) and tell the representative you want to lower your IRMAA due to a life-changing event.

2
Step 2

Fill in the event and your income

You'll name the event, the date it happened, and your income. You can report a drop that has already happened or one you expect this year or next, and you can give an estimate of your MAGI instead of a filed tax return. Social Security will ask for the return once you file it.

3
Step 3

Gather your proof

Attach the evidence the form asks for with your event. For stopping or cutting back work, that's documents like an employer statement, pay stubs or transfer documents, and if you can't get them, the form says Social Security will accept your signed statement on the form, under penalty of perjury, that you stopped working or took a job with reduced pay.

4
Step 4

Submit it to Social Security

You can sign in and complete SSA-44 online, upload a completed form, send it with your evidence by fax or mail, or schedule an appointment.

5
Step 5

Watch for Social Security's answer

Keep a copy of everything you sent, and keep an eye on your mail for the decision.

One practical note: you don't have to wait for the lower income to show up on a filed tax return. If you retired this year, you can report the drop you expect and give an estimate, which means fewer months paying the higher amount while you wait for a return to exist.

How to Appeal Your Medicare IRMAA Determination

SSA-44 is for a drop in income caused by a life-changing event. If your situation is different, one of these routes fits instead.

If your IRMAA is based on a tax return you later amended

An amended return isn't a life-changing event, so it's not on the SSA-44 list, but it isn't a dead end either. Social Security's page gives it its own instruction: call 1-800-772-1213 and tell the representative you want to lower your IRMAA because you had an amended income tax return.

If you think Social Security's decision is wrong: request a reconsideration

Separately from SSA-44, you have appeal rights. The initial IRMAA notice Social Security sends includes information about its determination and your appeal rights, so keep that notice handy. If you disagree with the decision, the first level of appeal is a request for reconsideration filed with Social Security, and someone other than the person who made the original decision handles it. The same appeal rules cover the Part D surcharge as the Part B one.

Before you file, make sure an appeal is the right tool. Social Security says you don't need one if you're asking for a new decision because a listed life-changing event lowered your income, or if you've shown it the information it used is wrong. Social Security's manual adds that you can request a new IRMAA decision and a reconsideration at the same time, but in most situations the new decision gets you the same result.

Here's how to file an IRMAA reconsideration request:

  • Online: Social Security calls this the fastest and easiest way to appeal.
  • In writing: complete a Request for Reconsideration, Form SSA-561-U2. You can use the form online or get a copy by calling 1-800-772-1213 (TTY 1-800-325-0778).
  • At your local Social Security office, or by asking out loud: under Social Security's IRMAA rules, it accepts oral requests as well as written ones.

Watch the deadline. You have 60 days from when you receive the IRMAA notice, and Social Security assumes you received it 5 days after the date printed on it unless you show you didn't. If you miss the window, you can ask for more time, and Social Security will extend it if you show good cause. You or your representative can file, and if you have a representative payee, the payee can request reconsideration for you. One wrinkle: a predetermination notice (a notice of planned action) isn't the decision itself and doesn't carry appeal rights, though Social Security must accept an appeal if you insist on filing one.

If the reconsideration doesn't go your way

After a reconsideration, an IRMAA appeal has three more levels. The next is a hearing before an Administrative Law Judge in the Department of Health and Human Services' Office of Medicare Hearings and Appeals, which you request on Form HA-501-U5 (Request for Hearing by Administrative Law Judge). After that comes review by the Medicare Appeals Council, and finally federal court. Keep in mind that if Social Security dismisses your appeal request, the dismissal itself can't be appealed further.

If the income figure from the IRS is wrong, or you don't have drug coverage

Some fixes don't go through Social Security's appeal at all. If you disagree with the MAGI amount Social Security received from the IRS, you have to correct it with the IRS. And if you're being charged the higher Part D amount but don't actually have Medicare drug coverage, call the Centers for Medicare & Medicaid Services (CMS) at 1-800-MEDICARE (1-800-633-4227; TTY 1-877-486-2048) to make a correction, since Social Security gets your drug-coverage information from CMS.

Frequently Asked Questions

Can I really get IRMAA removed, or just reduced?

Both can happen. You're asking Social Security to lower the surcharge or remove it, based on your more recent income. IRMAA is charged in income tiers, so income below the threshold means no surcharge, and lower income that's still above it can mean a smaller one.

What's the difference between filing SSA-44 and appealing IRMAA?

SSA-44 asks Social Security to use a more recent year's income because a qualifying life-changing event lowered it. If your IRMAA rests on a return you later amended, that's its own route: call 1-800-772-1213 and say so. An appeal, starting with a request for reconsideration, challenges Social Security's decision itself. You can file an SSA-44 request and an appeal at once, though in most situations the new decision from SSA-44 gets you the same result without an appeal.

Which tax year does my 2026 IRMAA use?

Your 2024 federal tax return, or your 2023 return if 2024 wasn't available. If a listed life-changing event lowered your income in 2025, you can ask Social Security to base your 2026 IRMAA on your 2025 income instead.

How long do I have to appeal an IRMAA decision?

For a reconsideration, the first level of IRMAA appeal, you have 60 days from receiving the notice, with more time possible for good cause; the reconsideration section above explains how Social Security counts the receipt date. A request for a new IRMAA decision through SSA-44 is a different request from an appeal, so you don't need to file an appeal to use it.

Does retirement count as a life-changing event?

Yes. You or your spouse stopping work or reducing your hours is one of the qualifying events on Form SSA-44, and retiring is stopping work. The event just has to fall in the same year as, or before, the tax year you ask Social Security to use.

What proof do I need to send with SSA-44?

It depends on the event. If you or your spouse stopped working or cut back your hours, Form SSA-44 asks for proof such as an employer statement, pay stubs or transfer documents, and if you can't get them, Social Security will accept your signed statement on the form, under penalty of perjury, that you stopped working or took a job with reduced pay.

Learn More

MedicareMedicare IRMAA: The Income Surcharge ExplainedIRMAA is the surcharge higher earners pay on Medicare Part B and Part D. See the 2026 brackets, the two-year income lag, and how to appeal with Form SSA-44. MedicareWhat Medicare Actually Costs in 2026How much does Medicare cost in 2026? Part A, B, C, and D premiums, deductibles, and coinsurance, plus IRMAA and ways to lower your Medicare costs. MedicareThe New Part D Premium Increase CapThe Inflation Reduction Act caps how fast the Medicare Part D base premium can rise at 6% a year. What the premium increase cap does, and what it doesn't.

Find personalized help sorting out a Medicare premium surcharge at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

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