Form SSA-44: Medicare Income-Related Monthly Adjustment Amount – Life-Changing Event

You may use this form if you received a notice that your monthly Medicare B (medical insurance) or prescription drug coverage premiums include an income-related monthly adjustment amount (IRMAA) and you experienced a life-changing event that may reduce your IRMAA.

Form SSA-44: Medicare Income-Related Monthly Adjustment Amount – Life-Changing Event: FAQs

  • Form SSA-44 is a form used by those with major life-changing events to request a reduction in income-related monthly adjustment amounts.

  • Please visit www.ssa.gov for more information on what qualifies as a major life-changing event.

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