# America's Elder Crisis, Medicare Edition

**URL:** <https://boards.straightdope.com/t/americas-elder-crisis-medicare-edition/937146>\
**Category:** Miscellaneous and Personal Stuff I Must Share\
**Created:** [March 4, 2021, 5:55am UTC](https://boards.straightdope.com/t/americas-elder-crisis-medicare-edition/937146 "2021-03-04T05:55:49Z")\
**Posts on this page:** 1\
**Showing post:** 378

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**Author:** ![LSLGuy](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lslguy/32/5813_2.png) [@LSLGuy](https://boards.straightdope.com/u/LSLGuy)\
**Post date:** [December 20, 2024, 1:00am UTC](https://boards.straightdope.com/t/americas-elder-crisis-medicare-edition/937146/378 "2024-12-20T01:00:37Z")

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> [@doreen](#):
>
> My understanding is that
> 
> 1. Whether you have to pay an IRMAA is calculated every year and 2) SSA calculates it from your tax return information and no application is needed

That matches my understanding.

AIUI …  
Every year until death they will assess IRMAA based on your tax return from 2 years ago _unless_ you file form SSA-44 to explain why a different number is applicable to your case.

Bottom line being:

While your year to year income is pretty stable, the SSA’s default behavior is close enough. Whenever you have a significant disruption in income or change in family situation you can file form SSA-44 to make the change in IRMAA assessment take place a year sooner than the default delayed 2-year look-back provisions would have.

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