Medicare premium went up? How to appeal IRMAA with Form SSA-44

What IRMAA is, and why the letter comes from SSA

The income-related monthly adjustment amount (IRMAA) is a surcharge on top of the standard Medicare premiums for people with higher incomes. Medicare sets the premiums, but Social Security decides who pays IRMAA, using income information from the IRS. That is why the notice comes from SSA, and why SSA is where you appeal.

The income SSA uses is modified adjusted gross income (MAGI): your adjusted gross income plus tax-exempt interest. For premiums in 2026, SSA generally uses your 2024 tax return. If that return is not available, it may use the year before and correct it later.

The 2026 brackets

The standard Part B premium for 2026 is $202.90 a month. These are the 2026 totals for Part B, and the extra amount added to your Part D plan premium, from the CMS fact sheet:

Married people who file separately and lived with their spouse have a separate, steeper table; check the CMS fact sheet linked below. One dollar over a threshold puts you in the next bracket, so small differences in reported income matter.

The two ways to challenge it

1. Your income went down: Form SSA-44

If your income dropped because of one of the life-changing events SSA recognizes, you can ask SSA to make a new determination using a more recent year's income, such as your 2025 return or your estimate for 2026. Form SSA-44, Medicare Income-Related Monthly Adjustment Amount, Life-Changing Event, lists eight events:

• Marriage
• Divorce or annulment
• Death of your spouse
• Work stoppage: you or your spouse stopped working.
• Work reduction: you or your spouse cut hours or pay.
• Loss of income-producing property through no fault of your own, such as a disaster or theft.
• Loss of pension income, such as a plan that ended or cut benefits.
• Employer settlement payment because of an employer's bankruptcy or reorganization.

Retiring is the most common one: a 2024 return with a full salary, and a 2026 with only Social Security and savings. A one-time spike that is not on this list, such as selling a house or stocks, or a large IRA withdrawal, is generally not a life-changing event, even if it pushed you over the line for one year.

2. SSA's information is wrong: reconsideration

If the tax information SSA used is wrong, for example you filed an amended return, SSA has the wrong filing status, or the figure does not match your return, ask for reconsideration on Form SSA-561. The appeal deadline is 60 days from receiving the IRMAA notice, and SSA treats the notice as received 5 days after its date. You can also ask SSA to use corrected tax information with proof such as an amended return and the IRS acknowledgment.

How to fill out SSA-44

1. Pick the event and the date it happened (month and year).
2. Show the income reduction: enter your adjusted gross income and tax-exempt interest for the year your income went down. If you have not filed that return yet, enter an estimate.
3. Attach proof of the event: for a work stoppage or reduction, a signed statement from the employer or recent pay stubs; for a death, the death certificate; for a marriage or divorce, the certificate or decree; for a pension loss, a letter from the plan.
4. Attach proof of income: a copy of the newer tax return, or proof that supports your estimate.
5. Sign and send it to your local Social Security office by mail or in person, or ask about other ways to submit it. Keep a copy and a dated receipt.

If you used an estimate, SSA will check it against the actual return later. If your real income turns out higher, SSA can adjust the IRMAA for that year. Estimate honestly.

Timing

• File SSA-44 as soon as the event happens and you know income will drop. You do not need to wait for a notice.
• If you are appealing a specific IRMAA notice, file within 60 days of receiving it.
• IRMAA is recalculated every year. A new-determination request covers the year you ask about; a new notice can come the following year based on newer income.

If SSA approves the request, it lowers or removes the extra amount for the premium year, and premiums already paid at the higher rate are adjusted. If SSA denies it, the decision explains how to ask for reconsideration.

Helping a parent with an IRMAA notice

A common case: a parent retired, or a spouse died, and the premium jumped because the tax return from two years ago still shows the old income. The parent signs the SSA-44; you can gather the papers and fill it in. For a widowed parent, death of spouse is the event to pick, and SSA then looks at the newer income, which often no longer includes a spouse's wages or pension.