Form preview picture

Get SSA-44 2020-2023

Form SSA-44 12-2017 Discontinue Prior Editions Social Security Administration Page 1 of 8 OMB No. 0960-0784 Medicare Income-Related Monthly Adjustment Amount Life-Changing Event If you had a major life-changing event and your income has gone down you may use this form to request a reduction in your income-related monthly adjustment amount. See page 5 for detailed information and line-by-line instructions. If you prefer to schedule an interview with your local Social Security office call 1-800-772-1213 TTY 1-800-325-0778. Name You may use this form if you received a notice that your monthly Medicare Part 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. To decide your IRMAA we asked the Internal Revenue Service IRS about your adjusted gross income plus certain tax-exempt income which we call modified adjusted gross income or MAGI from the Federal income tax return you filed for tax year 2016. If that was not available we asked for your tax return information for 2015. We took this information and used the table below to decide your income-related monthly adjustment amount. The table below shows the income-related monthly adjustment amounts for Medicare premiums based on your tax filing status and income. If your MAGI was lower than 85 000. 01 or lower than 170 000. 01 if you filed your taxes with the filing status of married filing jointly in your most recent filed tax return you do not have to pay any income-related monthly you should not fill out this form even if you experienced a life-changing event. Your prescription drug coverage monthly adjustment is If you filed your taxes as And your MAGI was Your Part B -Single -Head of household -Qualifying widow er with dependent child or -Married filing separately and you did not live with your spouse in tax year 85 000. 01 - 107 000. 00 107 000. 01 - 133 500. 00 133 500. 01 - 160 000. 00 More than 160 000 53. 50 133. 90 214. 30 294. 60 13. 00 33. 60 54. 20 74. 80 170 000. 01 - 214 000. 00 214 000. 01 - 267 000. 00 267 000. 01 - 320 000. 00 lived with your spouse during part of that tax year Let us know if your tax filing status for the tax year was Married filing separately but you lived apart from your spouse at all times during that tax year. STEP 1 Type of Life-Changing Event Check ONE life-changing event and fill in the date that the event occurred mm/dd/yyyy. If you had more than one life-changing event please call Social Security at 1-800-772-1213 Marriage Work Reduction Divorce/Annulment Loss of Income-Producing Property Death of Your Spouse Loss of Pension Income Work Stoppage Employer Settlement Payment Date of life-changing event mm/dd/yyyy STEP 2 Reduction in Income Fill in the tax year in which your income was reduced by the life-changing event see instructions on page 6 the amount of your adjusted gross income AGI as used on line 37 of IRS form 1040 and tax-exempt interest income as used on line 8b of IRS form 1040 and your tax filing status.

How It Works

ssa 44 printable form rating
33 votes

How to fill out and sign form ssa 44 online?

Get your online template and fill it in using progressive features. Enjoy smart fillable fields and interactivity. Follow the simple instructions below:

Are you still searching for a quick and practical solution to complete SSA-44 at a reasonable cost? Our service provides you with an extensive library of forms that are available for completing on the internet. It only takes a few minutes.

Keep to these simple instructions to get SSA-44 prepared for submitting:

  1. Find the document you need in the collection of legal templates.
  2. Open the template in the online editor.
  3. Look through the instructions to determine which information you have to provide.
  4. Click the fillable fields and put the required details.
  5. Add the date and place your electronic signature as soon as you fill out all other fields.
  6. Examine the completed document for misprints and other errors. In case there?s a necessity to correct something, our online editor as well as its wide variety of instruments are available for you.
  7. Download the filled out document to your computer by clicking on Done.
  8. Send the electronic form to the intended recipient.

Filling out SSA-44 does not really have to be complicated any longer. From now on easily cope with it from home or at the office straight from your mobile or desktop computer.

Get form

Experience a faster way to fill out and sign forms on the web. Access the most extensive library of templates available.

Video instructions and help with filling out and completing social security form ssa 44

Dodge legal professional costs for acquiring and completing your Form. Discover all the tips and tricks you require in our video guide to begin saving money on official papers.

Ssa gov forms ssa 44 ext pdf FAQ

Get This Form Now!

Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.

Keywords relevant to social security irmaa

  • social security form 44
  • form ssa 44 for 2022
  • ssa 44 printable form 2020
  • ssa 44 life changing event
  • form ssa 44 for 2023
  • ssa44
  • print friendly form ssa 44
  • ssa gov forms ssa 44
  • ssa life changing event form
  • life changing event form ssa 44
  • social security forms ssa 44
  • social security irmaa form
  • irmaa form
  • ssa 44 form for 2021
  • ssa gov form 44
If you believe that this page should be taken down, please follow our DMCA take down processhere.
Ensure the security of your data and transactions

USLegal fulfills industry-leading security and compliance standards.

                            VeriSign logo picture

    VeriSign secured

    #1 Internet-trusted security seal. Ensures that a website is free of malware attacks.

  • Accredited Business

    Guarantees that a business meets BBB accreditation standards in the US and Canada.

                            TopTenReviews logo picture

    TopTen Reviews

    Highest customer reviews on one of the most highly-trusted product review platforms.