Get your Form SSA-44 in 3 easy steps

  • 01 Fill and edit template
  • 02 Sign it online
  • 03 Export or print immediately

What is SSA-44 Form?

The SSA form 44 is also called Medicare Income-Related Monthly Adjustment Amount – Life-Changing Event. It is not the most popular form. Yet, you may need it to record the major life-changing event that also had an impact on the decrease of your income. In this case, you have to fill the form SSA-44 to ask the Social Security Administration for the reduction of the monthly adjusted income-related amount.

The more income you receive the more money you pay for Medicare. However, the situation can be changeable from time to time. If one year is not as good as the previous one, and you receive less income, you have to notify the administration about the change of the plan.

Apply the document to get a reduction in the IRMAA. If your premiums to the prescription drug or Medicare part B rely on IRMAA the document must be sent once you received the notification on the income reduction. If you are not connected to the IRMAA you don’t need to fill SSA 44 form.

What I need the SSA-44 Form for?

  1. You have to provide form SSA 44 in case you are a taxpayer who has the Medicare program with a premium account related to IRMAA. This program is connected to the salary you have. If there was a life-changing event in your life that decreases your salary, you can apply for the reduction to the Social Security Administration;
  2. If you used plan B of Medicare, but now you can’t pay as much money as you used to, you have to connect the administration and send the form;
  3. If you don’t pay the IRMAA you don’t need the form at all. It means that your income may not pass the original threshold for the program.

Form SSA-44 on PDFLiner

How to Fill Out SSA-44 Form?

The IRS form SSA 44 is something you need to report to the Social Security office whenever you use the IRMAA program of Medicare. The form is available on the SSA official website as well as on the IRS website. You can check it out there and even download it on your device. However, you will not be able to complete it there. If you want to fill out the form online, you have to use PDFLiner.

This editing service offers a wide range of tools. All you need is to open IRS form SSA-44 and fill in the empty sections. Follow the instructions for it below:

  1. Provide the information about you, including your name and SSN;
  2. Describe your life-changing event that decreased your usual income. You have to read all the statements and pick only one from them. Put the tick in the appropriate box;
  3. Put the date of the life-changing event;
  4. Calculate the reduction in income, and put it in the table. Describe the adjusted gross income and the tax-exempt interest. Pick one of the statements on your tax filing status for the year and put a tick there;
  5. Include the information on the modified adjusted gross income. If you have a gross income higher or the same next year you have to skip this section and move to another one;
  6. Attach the document required in the form;
  7. Out your signature, address, phone number, and ZIP code in the last section.

Fill Form SSA-44 on PDFLiner

Organizations that work with SSA-44 Form

  • Social Security Administration;
  • The US officials.

Form Versions

2020 Fillable Form SSA-44 (2020) Fill Out Form

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Fillable online Form SSA-44
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