What is Form SSA-44?

1 min read by Rachel Carey Last updated December 7, 2023

If you require a review or change to your Medicare premium, this article details what you need to know when filling out and submitting your Form SSA-44.


  • An SSA-44 Form reviews your Medicare premium. 

  • A new form must be submitted whenever your household income changes. 

  • All SSA-44 Forms must be submitted in person. 

  • A financial advisor can help you to fill out your Form SSA-44. 

What is a Form SSA-44? 

The SSA-44 Form allows you to review your Medicare premium in the event of a significant life change that has impacted your household income. Career shifts, marriage, divorce, retirement, and the sale of an income-providing property are some of the most common examples of such changes.  

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The form enables you to adjust your Medicare premiums depending on whether your monthly income has increased or decreased as a result of these significant life events.  

If you have experienced one of these changes and require an SSA-44 Form, you can request one from the Social Security Administration (SSA) for review. This allows the SSA to review whether your Medicare premiums need to be increased. This adjustment is referred to as an income-related monthly adjustment amount (IRMAA).  

If you are not certain whether your situation warrants an IRMAA, you can contact the SSA for more information or speak to a financial advisor to provide guidance and support.  

Who needs to fill out the SSA-44 Form? 

Big life changes happen to everyone, and many of them can affect your monthly income. People who need to fill out the SSA-44 Form are those who may have recently experienced one of the following events: 

  • Marriage  

  • Divorce or annulment  

  • Death of a spouse 

  • Work reduction 

  • Work stoppage  

  • Loss of income-inducing property  

  • Loss of pension income  

  • Employer settlement payment  

If you have experienced one of the above life changes, it’s crucial that you submit your Form SSA-44 as soon as possible. Delaying submission results in having to pay higher premiums than necessary, so it is wise to tackle them swiftly and efficiently.  

If you have experienced more than one of these changes, you will need a different form. Furthermore, if your income is higher than a certain threshold, your IRMAA is considered complete, and you will not need to fill out the SSA-44 at all.  

You only need to fill out the SSA-44 Form if you have experienced one major life event that has impacted your monthly household income. For example, if you recently got divorced from an ex-partner whom you shared a dual-income household with, you are eligible to request to submit an SSA-44 Form to the SSA.  

If you’re not sure whether your modified adjusted gross income (MAGI) already qualifies for IRMAA, you can use the following tax table as a reference:

MAGI (Single)MAGI (Dual)Part B (Monthly Premium)Part D (Monthly Premium)
< $97,000 <= $194,000 $164.90 Your plan premium
$97,000 up to $123,000 $194,000 up to $246,000 $230.80 $12.20 + your plan premium
$123,000 up to $153,000 $246,000 up to $306,000 $329.70 $31.50 + your plan premium
$153,000 up to $183,000 $306,000 up to $366,000 $428.60 $50.70 + your plan premium
$183,000 up to $500,000 $366,000 up to $750,000 $527.50 $70.00 + your plan premium
> $500,000 > $750,000 $560.60 $76.40 + your plan premium

Income thresholds, as set by Medicare and the SSA, are subject to change. You can use the above table as a guideline, but it is important to check with SSA prior to filling out your SSA-44 Form.  

How to fill out Form SSA-44?  

Knowing how to fill out form SSA-44 can feel like a daunting process, especially in the wake of a big life change. But it can be broken down into four simple steps:  

Step 1: Indicate your life-changing event  

The first thing the SSA-44 Form will need from you is information about why your income level has changed. You will need to state what the change is and the date on which it occurred.  

Step 2: Provide your financial details  

The next section entails providing your current gross income, tax-exempt interest income, and your tax filing status as per your most recent IRS Form.  

Step 3: Estimate the impact  

At this point of the Form SSA-44, you will need to provide a numerical estimation of how much your income has been or will be affected by this life change.  

Step 4: Submit qualifying documents  

Finally, you’ll need to provide documents supporting the claims around your life-changing event. Documents like marriage and death certificates are two examples.  

While filling out this important form, you may encounter some issues. This is especially true if you have experienced multiple life changes or have recently changed your insurance provider. If this is your first time filling out an SSA-44 Form, you will need to go in prepared with some background knowledge of IRMAA terminology and an understanding of how to proceed accordingly.  

Obtaining professional financial advice in this area is beneficial to anybody who is undergoing this process for the first time or lacks confidence in navigating it alone.  

How to submit Form SSA-44? 

One of the most common questions on the topic of filling out the SSA-44 Form is, “Can I fill SSA-44 online?” Unfortunately, the answer is no.  

At present, the only legitimate way to submit a filled-in SSA-44 Form is to do so manually via mail to your closest Social Security office, or you can deliver it to the same location in person.  

Submitting the SSA-44 manually can be inconvenient, but it is the only option when it comes to handing in this form. If you require help navigating its successful submission, hiring a financial advisor can expedite the process.  

How do I navigate the SSA-44 Form? 

Understanding what the SSA-44 Form is and how to properly fill it out and submit it is a crucial learning curve for any income-earning adult.  

This important document is your go-to form any time your income is affected due to sudden life changes, such as divorce, death, marriage, or loss of work. The SSA needs to know whether your income status has changed and, if so, why in order to appropriately administer an IRMAA update.  

In the midst of life’s unpredictability and change, having to deal with unfamiliar forms and social security issues can be stressful. If you feel that you could benefit from further clarity or instruction, Unbiased can help. Finding a trusted financial advisor who can guide you through financial changes is easy. Simply answer a few questions, and we’ll match you with an SEC-regulated advisor.

Senior Content Writer

Rachel Carey

Rachel is a Senior Content Writer at Unbiased. She has nearly a decade of experience writing and producing content across a range of different sectors.

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