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Welcome

Let's prepare your IRMAA appeal.

IRMAA is the extra amount Medicare charges when your income was above a certain level. We'll walk through everything Social Security needs to lower it, and prepare your two appeal forms (SSA-44 and SSA-795) in plain English, one question at a time. Most clients finish in about 15 minutes, and your progress saves automatically.

What you'll need:
  • The IRMAA notice you received from Social Security
  • An estimate of your reduced income (or your most recent tax return)
  • Documentation of your life-changing event

We never ask for your Social Security or Medicare number. You'll simply write your SSN by hand on the finished forms before submitting them to SSA.

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Who is appealing?

If you and your spouse both have Medicare and both received an IRMAA notice, we'll prepare appeal forms for both of you. Each spouse needs to submit their own SSA-44 and SSA-795.

Tell us about yourself.

This is the person who received the IRMAA notice. Your name must match your Social Security card exactly.

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Now tell us about your spouse.

Your spouse will receive their own SSA-44 and SSA-795 to sign separately. Their information must match their Social Security card exactly.

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Same address as you? If your spouse lives at the same address you entered, you can leave this section blank. We'll use yours.

Your details are saved.

Next, a few questions about the IRMAA notice Social Security sent you.

What year does the higher premium apply to?

Your IRMAA notice tells you which calendar year the higher Medicare premium covers.

What tax year did SSA use to determine your IRMAA?

Listed on your IRMAA notice. SSA usually uses your return from two years before the premium year.

What income amount is your IRMAA based on?

Your IRMAA notice states the modified adjusted gross income (MAGI) Social Security used. Entering it lets us confirm how far your income has dropped.

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Found on your IRMAA notice from Social Security. If you can't locate it, leave this blank.

What life-changing event applies to you?

SSA only adjusts your premium for these eight specific events. If more than one applies, choose the most significant.

Tell us what happened.

The date and a few quick details. We'll turn what you tell us here into the formal sworn statement on your Form SSA-795 — you don't need to write anything polished.

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A few words is fine — include a dollar amount if you know it.
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This tells us who to write each statement about, so the wording is accurate.
Please choose whose event this was.

That's the event details covered.

Now we'll look at your income for the year you're asking Social Security to use.

What is your tax filing status?

For the year your reduced income applies to — the year we'll ask SSA to use.

Your income after the event.

Tell us what your income looks like in the more recent tax year — the one we'll ask SSA to use instead of the older return on your notice.

This is the year you want Social Security to look at instead of the older return on your notice. It's usually the year your event happened, or the year after.
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Line 11 of your 1040.
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Line 2a of your 1040. Enter $0 if you don't have any.
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MAGI = AGI + Tax-exempt interest. SSA adds these together to determine your IRMAA. We'll calculate this for you on the review screen.

Will the following year be even lower?

Sometimes the year after your reduced-income year is even lower — for example, a first partial year of retirement followed by a full year with no wages. If that's you, we can include it now so SSA adjusts both years at once. Only do this if you're confident; otherwise skip — you can always file again later.

Which documents do you have right now?

Social Security usually wants proof of your event. It's fine if you don't have it yet. You can finish today and gather it before you mail your packet. If proof is missing, Social Security usually gives you about 30 days to send it, so it's best to include it with your packet.

For your event, SSA accepts:

We name these documents in your signed statement to Social Security, so only check what you actually have. If you're not sure, leave it unchecked. Your filing guide explains how to get anything that's missing.

We have everything we need.

Last step: review your answers and sign so we can prepare your forms.

· Review

Make sure we've got it right.

Review every section below. Tap "Edit" to make changes. Everything here goes onto your forms exactly as written, so it needs to be accurate.

Disclosures & Terms

Your agreement with us

Please read carefully. By signing, you confirm the information you provided is accurate and you understand the limits of our service.

Key things to remember before submitting

1. Everything you told us must be true. Your forms are signed under penalty of perjury, and we build them only from what you provide.

2. We can't guarantee approval — but we do guarantee your money. Social Security makes the final decision on your appeal. If they deny it, send us the denial notice and we refund your fee in full. See our Refund Policy.

3. You're responsible for repayment if figures are wrong. goodbyeirmaa.com is not liable for any funds, premiums, or penalties that SSA, CMS, or the IRS may ask you to repay. You submit the final forms to SSA yourself.

1. Accuracy of information

You ("Client") confirm that all information provided in this questionnaire is true, complete, and accurate to the best of your knowledge. goodbyeirmaa.com prepares Form SSA-44 and Form SSA-795 solely on the basis of the information you submit. We do not verify, audit, or independently confirm the accuracy of any income figures, dates, employment details, life-changing events, or supporting documentation you describe.

2. No legal, tax, or financial advice

goodbyeirmaa.com is a service of GoodMedicare LLC. We are not a law firm, accounting firm, or registered tax advisor, and our services do not constitute legal, tax, financial, or actuarial advice. Nothing on this site or in any communication with us creates an attorney-client, fiduciary, or advisory relationship.

3. No guarantee of outcome

The decision to approve or deny an IRMAA appeal rests entirely with the Social Security Administration. goodbyeirmaa.com does not and cannot guarantee any specific outcome, including approval of your appeal, reduction of premiums, or refund of previously paid amounts.

3a. Money-back guarantee on denial

If you file the packet we prepare and the Social Security Administration issues a written decision denying your request, we will refund your fee in full. To claim it, email a copy of the denial notice to support@goodbyeirmaa.com within 12 months of delivery of your packet; we verify it within three business days and refund to your original payment method. A partial reduction is an approval, not a denial. The guarantee covers our fee only — it does not cover premiums, surcharges, or amounts owed to any agency. Full terms: Refund Policy.

4. Limitation of liability

Client acknowledges and agrees that:

  • goodbyeirmaa.com is not liable for any false, inaccurate, incomplete, or misleading information provided by Client, regardless of whether such inaccuracy was intentional, negligent, or accidental.
  • goodbyeirmaa.com is not responsible for the repayment of any funds, premiums, surcharges, penalties, interest, or amounts owed to the Social Security Administration, the Centers for Medicare & Medicaid Services, the Internal Revenue Service, or any other government agency, whether arising from a denied appeal, an overturned approval, an audit, or otherwise.
  • goodbyeirmaa.com's total aggregate liability for any claim arising from the services provided shall not exceed the fees actually paid by Client for those services.

5. Submission to SSA

goodbyeirmaa.com prepares your appeal documents for your review and signature. Final submission of forms to SSA is the Client's responsibility, including ensuring that supporting documentation is included and that the package is delivered to SSA via mail, fax, or in-person appointment within applicable deadlines.

6. Privacy

Information you provide is transmitted securely and used solely to prepare your appeal. We do not sell your personal information.

7. Penalty of perjury

The signed SSA forms include a declaration under penalty of perjury. By providing this information and signing your forms, you affirm that all statements are true. Knowingly providing false information to SSA is a federal crime.

Sign & submit

Sign and submit.

Your signature here authorizes goodbyeirmaa.com to prepare your SSA-44 and SSA-795 forms. You'll need to separately sign the physical SSA forms before they are submitted to Social Security.

Your signature

Match your Social Security card.
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Spouse's signature

Must match their Social Security card.
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What happens next: Within 1 business day, we prepare your SSA-44 and SSA-795 forms based on your answers. We'll email your completed forms to you as PDF attachments, together with a step-by-step guide for printing, signing, and submitting them to Social Security.

Your answers are in. Thank you.

We'll take it from here. Your completed SSA-44 and SSA-795 will be reviewed and emailed to within 1 business day — no action needed from you right now. A confirmation email is already on its way.

Intake complete
You're done here
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We prepare your forms
Within 1 business day
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You submit to SSA
We'll send a step-by-step guide
Your reference number:
Save this for any questions or status updates.
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Recommended: Save a copy now for your records. Your saved file includes everything you submitted, the disclosures you agreed to, and your signature. We'll also email your appeal kit separately within 1 business day.

Where to find the tax year on your IRMAA notice

Example SSA IRMAA notice showing the tax year highlighted

On your Initial IRMAA Determination notice, look for the line that reads "based on your YYYY income tax return." That year is what SSA used to calculate your IRMAA.