Appeal IRMAA with Form SSA-44

You opened a letter saying your Medicare Part B and Part D premiums now include an income-related monthly adjustment amount. That determination is not always final: if your income has dropped because of a qualifying life-changing event, or the tax data behind the letter is wrong or outdated, you can ask Social Security to use different figures. This page covers what triggered the letter, the 8 events form SSA-44 accepts, the evidence SSA asks for, the paths that work when no event applies — and the one common request that does not qualify.

Form SSA-44 (12-2025 edition) · Two-year MAGI lookback (2026 IRMAA uses 2024 income) · Last reviewed 2026-08-15

What triggered the determination letter

SSA does not look at this year's income. To set your 2026 IRMAA it asked the IRS for your modified adjusted gross income — adjusted gross income (line 11 of form 1040) plus tax-exempt interest (line 2a) — from the return you filed for tax year 2024. If that return was not available, SSA used your 2023 information instead. That is the two-year lookback, and it is why a one-time income spike two years ago — a large withdrawal, a property sale, a Roth conversion — shows up as a Medicare surcharge now.

The thresholds are hard cliffs: one dollar over a line puts you in the next tier for the whole year. These are the 2026 tiers the letter is applying:

2026 IRMAA — Single, Head of Household, or Married Filing Separately (lived apart)
Tier MAGI (2024 income) Part B surcharge / mo Part D surcharge / mo Total surcharge / mo Total Part B premium / mo
0$0 – $109,000$0.00$0.00$0.00$202.90
1$109,001 – $137,000$81.20$14.50$95.70$284.10
2$137,001 – $171,000$202.90$37.50$240.40$405.80
3$171,001 – $205,000$324.60$60.40$385.00$527.50
4$205,001 – $499,999$446.30$83.30$529.60$649.20
5$500,000 and above$487.00$91.00$578.00$689.90
2026 IRMAA — Married Filing Jointly
Tier MAGI (2024 income) Part B surcharge / mo Part D surcharge / mo Total surcharge / mo Total Part B premium / mo
0$0 – $218,000$0.00$0.00$0.00$202.90
1$218,001 – $274,000$81.20$14.50$95.70$284.10
2$274,001 – $342,000$202.90$37.50$240.40$405.80
3$342,001 – $410,000$324.60$60.40$385.00$527.50
4$410,001 – $749,999$446.30$83.30$529.60$649.20
5$750,000 and above$487.00$91.00$578.00$689.90

Surcharges are per person; a couple where both spouses are on Medicare pays double the figures above. Full table, premiums chart and CSV download: 2026 IRMAA brackets. A “significant” MAGI reduction, in SSA's words, is one that decreases or eliminates the IRMAA — i.e. it moves you down at least one tier of this table. If a more recent tax year leaves you in the same tier, a request will not change your premium.

The 8 life-changing events on form SSA-44

Form SSA-44 (“Medicare Income-Related Monthly Adjustment Amount — Life-Changing Event”) is the request for SSA to make a new initial determination using a more recent tax year than the one the lookback picked. Step 1 of the form lists exactly eight events, and SSA's operations manual states the list is exclusive — an income drop that is not one of these eight does not qualify:

Step 1 of form SSA-44: qualifying life-changing events (form's own wording)
Life-changing event Use this category if…
MarriageYou entered into a legal marriage.
Divorce/AnnulmentYour legal marriage ended, and you will not file a joint return with your spouse for the year.
Death of Your SpouseYour spouse died.
Work StoppageYou or your spouse stopped working or reduced the hours that you work.
Work Reduction
Loss of Income-Producing PropertyYou or your spouse experienced a loss of income-producing property that was not at your direction — e.g. not a voluntary sale or transfer. This includes loss of real property in a Presidentially or Gubernatorially-declared disaster area, destruction of livestock or crops from natural disaster or disease, loss from arson, or loss of investment property to fraud or theft.
Loss of Pension IncomeYou or your spouse experienced a scheduled cessation, termination, or reorganization of an employer's pension plan.
Employer Settlement PaymentYou or your spouse receive a settlement from an employer or former employer because of the employer's bankruptcy or reorganization.

The event may have happened at any time in the past — what matters is that it caused the MAGI reduction in the tax year you are asking SSA to use. SSA's manual gives retirement, a lay-off and the sale of a business as its examples of a work stoppage (POMS HI 01120.030), which makes retirement by far the most common case: the lookback prices your premiums off your last full working years, and “Work Stoppage” is the checkbox that tells SSA those years no longer describe you. Each report covers only the person making it; a spouse affected by the same event files their own request.

What counts as evidence

A request needs proof of two separate things: the event and the lower MAGI.

1. Evidence of the life-changing event

SSA wants original documents or certified copies (originals are mailed back if you file by mail, or shown to an SSA employee at an office). The form's own evidence list, by event:

Evidence per event (form SSA-44, page 8)
EventPreferred evidence
MarriageAn original marriage certificate or a certified copy of a public record of marriage.
Divorce/AnnulmentA certified copy of the decree of divorce or annulment.
Death of Your SpouseA certified copy of a death certificate, of the public record of death, or of a coroner's certificate.
Work Stoppage or ReductionAn original signed statement from your employer, copies of pay stubs, or documents showing a transfer of your business. Without those, SSA accepts your signed statement on the form, under penalty of perjury, that you partially or fully stopped working or accepted reduced compensation.
Loss of Income-Producing PropertyAn insurance adjuster's statement of loss or a letter from a State or Federal government about the uncompensated loss; for investment fraud, also proof of conviction for the theft.
Loss of Pension IncomeA letter or statement from your pension fund administrator explaining the reduction or termination of your benefits.
Employer Settlement PaymentA letter from the employer stating the settlement terms of the bankruptcy court and how it affects you or your spouse.

2. Evidence of the lower MAGI

If you have already filed the return for the year you want SSA to use, provide a signed copy of the return or an IRS transcript. If you have not filed yet — the usual situation the year you retire — you give an estimate of that year's AGI and tax-exempt interest, signed under penalty of perjury. SSA acts on the estimate now and verifies it with the IRS later; if your estimate changes, you must update SSA or the difference is corrected retroactively. The form also lets you add a second estimate for next year if the event lowers that year too — without one, SSA reuses the first year's estimate.

No life-changing event? The other paths

A new initial determination is also available when the data behind the letter is wrong or superseded — no SSA-44 category required:

Separately from all of the above, you can request a reconsideration — a formal appeal of the determination itself — and SSA permits filing an appeal and a new-determination request at the same time, if filed within the appeals period.

Where and how to file

A Roth conversion is not a life-changing event

SSA's operations manual treats a request based on a one-time income spike as a non-qualifying event, and it names the cases: “Capital gains from the sale of property; Lottery winnings; Casino winnings; Conversion of an IRA; or Cashing bonds.” (POMS HI 01120.005D.) Because the life-changing-event list is exclusive, a request whose only basis is “my income was high two years ago because I converted” is processed as non-qualifying and the surcharge stands.

That asymmetry is the planning lesson. The event list exists for income that fell; income you deliberately added in the lookback year is treated as a choice, and the choice gets priced two years later, one full year of surcharge per tier crossed. So the IRMAA cost of a conversion is decided before you convert — by sizing the conversion against the thresholds in the tables above (and next year's, if you are converting across years), not by asking for relief afterward.

Sizing a conversion against these cliffs is the hard part: convert too much in one year and the extra Medicare surcharge can eat into the tax you saved. Model IRMAA-aware conversion sizing with the Roth Conversion Planner ($99) →

Get the official 2027 numbers the week CMS publishes them

Common questions

Can I appeal my IRMAA surcharge?
Yes, on specific grounds. If you had one of the 8 qualifying life-changing events on form SSA-44 — marriage, divorce/annulment, death of your spouse, work stoppage, work reduction, loss of income-producing property, loss of pension income, or an employer settlement payment — you can ask SSA to use a more recent tax year. If your tax data was wrong or has been amended, you can ask SSA to use the corrected figures. You can also request a reconsideration of the determination itself.
Is a Roth conversion a life-changing event for IRMAA?
No. SSA's list of life-changing events is exclusive, and its operations manual (POMS HI 01120.005) names conversion of an IRA — along with capital gains from a property sale, lottery or casino winnings, and cashing bonds — as a non-qualifying event. A request based only on a one-time income spike like a conversion does not qualify for a new determination. The surcharge from a conversion year is managed before you convert, by sizing the conversion against the thresholds.
What evidence does SSA need for an IRMAA appeal?
Two things: proof of the life-changing event (original documents or certified copies — for example a marriage certificate, a certified divorce decree or death certificate, a signed employer statement or pay stubs, an insurance adjuster's statement of loss, or a pension administrator's letter) and proof of the lower MAGI (a signed copy of your tax return or an IRS transcript; an estimate is accepted if you have not filed yet, and SSA later verifies it with the IRS).
Where do I send form SSA-44?
Take or mail the completed form with your evidence to your local Social Security office — SSA returns original documents. The form itself is optional: you can instead call 1-800-772-1213 (TTY 1-800-325-0778), 7 a.m. to 7 p.m. on business days, and request an appointment at a field office.
Which year's income set my 2026 IRMAA?
Your 2024 MAGI — adjusted gross income plus tax-exempt interest — from the return you filed for tax year 2024, via the two-year lookback. If that return was not available, SSA used your 2023 information, and in that case you may ask SSA to use the 2024 figures instead.
Sources & last updated. Form SSA-44 (12-2025 edition, OMB No. 0960-0784), including its Step 1 event list, Step 4 documentation rules and page-8 evidence table; SSA Program Operations Manual System (POMS) HI 01120.001 (TN 26, 06-26), HI 01120.005 (TN 15, 10-23) and HI 01120.030; 20 CFR 418.1201–418.1270. 2026 IRMAA tier thresholds and Part B/Part D surcharge amounts as published by CMS for 2026, restated from QuantCalc's canonical 2026 IRMAA bracket table (standard Part B base premium $202.90/month). Last reviewed: 2026-08-15.
This page is an educational reference and is not tax, legal or financial advice. Filing rules and thresholds are set by SSA, CMS and the IRS; verify current figures and procedures against official SSA publications (form SSA-44 and ssa.gov) before acting.