What is Form SSA-44?
Asks Social Security to lower or remove the income-related monthly adjustment amount (IRMAA) added to your Medicare Part B and prescription drug premiums, because a life-changing event such as retirement, a work reduction, marriage, divorce or a spouse's death has reduced your income. You report the more recent year's income and send proof.
What’s on Form SSA-44
The 2025 edition has 8 pages. FileIt asks for it in 5 parts, and it is signed by Medicare beneficiary:
- Your name and Social Security numberMedicare beneficiary
- Step 1: Type of life-changing eventMedicare beneficiary
- Step 2: Your reduced income (a year after the one SSA used)Medicare beneficiary
- Step 3: Will your income be even lower next year?Medicare beneficiary
- Step 5: Contact detailsMedicare beneficiary
Fill out Form SSA-44 online with FileIt
- Pick the person. Choose someone from People and FileIt fills in their name, date of birth, address and other details it already knows.
- Answer plain-language questions. One part of the form at a time, with the official help text beside each question — 30 fields in all. Your answers save as you go.
- Check the live preview. Watch your answers land on the real Social Security Administration (SSA) form, and let FileIt do any worksheet arithmetic.
- Generate the official PDF. FileIt prints your answers into the agency’s own PDF and files it in that person’s folder in your vault. Sign it, or send it for e-signature.
FileIt fills the form — it never files or submits anything for you. Deliver the finished form to whoever asked for it, the way the form’s instructions say.
Start Form SSA-44 now — it’s freeOfficial sources
- Blank form (PDF), published by Social Security Administration (SSA): https://www.ssa.gov/forms/ssa-44.pdf
- Official instructions and guidance: https://www.ssa.gov/forms/ssa-44.pdf
- Edition shown on this page: Form SSA-44 (12-2025) (OMB No. 0960-0784) (checked 2026-09-28).
FileIt is not affiliated with or endorsed by Social Security Administration (SSA) or any government. This page explains the form in general terms and is not legal, tax or immigration advice. Always read the official instructions, and check that you are using the edition the recipient accepts.