When it comes to appealing IRMAA you need to have a Qualifying Circumstance and you will also need to fill out an SSA 44 Form which you can download here
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Open in new tab When filling out the form please fill in the fist page information at the top
- Name
- Social Security Number
From here please fill in the information for the next 5 Steps.
Step #1: Type of Life-Changing Event
Select your Life Changing Event which are apart of the Qualifying Circumstances.
For a detailed explanation of each Life Changing Event click here
Step #2: Reductions in income that have Already Occurred
The SSA 44 Form is simply asking if your income is different from what the IRS is reporting from your previous tax-return.
For those who are new to Medicare please do not be alarmed if your reportable income will still place you into IRMAA. The IRS is providing your tax return from 2 years ago.
You are appealing IRMAA on the grounds that:
- You are no longer working.
- You are no longer earning that amount of income.
- You did NOT earn that amount of money while in Medicare.
For the other Life Changing Events other than Work Reduction of Work Stoppage you are also appealing IRMAA on the grounds that your income going forward will not be that high.
Step #3: Anticipated Reductions in Modified Adjusted Gross Income Next Year
This is where you will make your case that one of those Life Changing Events will lower your income going forward.
If you do not know what your income will be going forward you can fill in $0.00, but please try to provide the best estimate possible.
Step #4 – Documentation
For any Life Changing Event you will have to provide some documentation. For a list if what is typically required for each Event click here.
Step #5: Signature
Once the SSA 44 Form is filled out it is highly recommended that you go to you local Social Security Office and meet with a Field Agent.
Field Agents have the authority to waive any IRMAA Surcharges if there is adequate documentation
