Medicare’s One-Time $90 Part B Rebate Goes to 20.8 Million Eligible Enrollees, but Medicare Advantage Members Are Excluded

The Centers for Medicare & Medicaid Services is sending a one-time $90 payment to about 20.8 million people in Original Medicare Part B this month, meant to offset part of the October premium. The money comes from the Medicare Improvement Fund, and it skips millions of Medicare enrollees entirely. Anyone in a Medicare Advantage plan is not eligible.

The details come from the agency’s frequently asked questions page on the rebate, dated Oct. 3, which spells out who qualifies, how the money moves and where to call if it does not arrive.

The three tests for the $90 payment

According to CMS, a beneficiary must clear three tests to get the rebate. The person must be enrolled in Original Medicare Part B and live in the United States. The person must not receive Medicaid help with premiums. And the person must not pay the income-related monthly adjustment amount, or IRMAA, the surcharge charged to higher-income enrollees.

No application is needed. Juliette Cubanski, director of KFF’s program on Medicare policy, told the Associated Press that the payment is automatic and that “people don’t have to call or sign up.”

For context, the standard Part B premium is $202.90 a month in 2026, up $17.90 from 2025, according to the CMS notice in the Federal Register. A $90 payment covers a little less than half of one month’s standard premium.

Medicare Advantage members and others left out

The biggest group shut out is Medicare Advantage enrollees. The AP put that number at roughly 35 million people, and KFF told the AP they make up more than half of Medicare’s 64.2 million beneficiaries. For many of them, the premium picture already looks different: KFF’s 2026 analysis found that 75 percent of people in Medicare Advantage plans with drug coverage pay no premium beyond Part B itself.

Two other groups are excluded by the CMS criteria. KFF told the AP that about 12 million low-income older adults and people with disabilities who get premium assistance are left out. Higher-income enrollees who pay IRMAA are also ineligible. Under the 2026 Federal Register notice, that surcharge starts for individuals with modified adjusted gross income above $109,000, or $218,000 for joint filers.

Cubanski also said the payment “might be helpful for people but it might not go very far.”

Deposits on Oct. 8, checks later in the month

CMS said most eligible people would get a direct deposit from the Social Security Administration on or around Oct. 8, followed in mid-October by an email or letter from the President. That deposit date has now passed.

Beneficiaries without direct deposit are getting a paper check from the U.S. Department of the Treasury later in October, mailed to the address Medicare has on file. CMS says the check is labeled “Medicare Improvement Fund Payment; $90 Payment to Offset October Premium.”

The rebate does not change the monthly premium itself. A Chase explainer published Oct. 20 described it as a one-time payment, with the standard Part B premium still at $202.90.

The fund behind the money

The Medicare Improvement Fund was created by Section 7002 of the Supplemental Appropriations Act of 2008, which set it up “to make improvements under the original fee-for-service program under parts A and B,” according to CMS. The agency says Congress has drawn on the fund about 20 times to offset new spending, including a $20.7 billion withdrawal in 2010.

Fierce Healthcare reported that the fund held about $2 billion and that the White House announced the rebate on Oct. 5. A White House fact sheet said the fund “has never before been utilized” to improve the program, and a CMS Q&A said “the best way to improve Medicare is to put healthcare dollars back where they belong.”

The plan drew criticism from Democrats. Sen. Ron Wyden of Oregon, the top Democrat on the Senate Finance Committee, called it “another desperate attempt by a failed president” to deflect frustration with the administration’s agenda, the AP reported. White House spokeswoman Allison Schuster said the administration is “enabling Americans to take control of their health.”

Checking on a payment that never showed

CMS lists two phone numbers. To ask whether someone is eligible, the agency points to 1-800-MEDICARE (1-800-633-4227). To check the status of a payment, it points to the Social Security Administration at 1-800-772-1213, a line CMS said would take those calls starting Oct. 15.

Before calling, it helps to confirm the basics. Someone who switched to a Medicare Advantage plan, pays IRMAA or has Medicaid paying the Part B premium would not be in line for the money under the CMS rules. Someone who meets all three tests but lacks direct deposit may simply be waiting on the mail, since Treasury checks are still going out this month.

The payment is also separate from the 2027 premium. CMS has not yet announced next year’s Part B premium, and that figure, not the October rebate, will set how much comes out of Social Security checks starting in January, the same math that left some retirees with a smaller check after the 2026 raise. AARP reported that the Medicare trustees project a 2027 standard premium of $209.50 a month, which would be $6.60 more than today. Over a year, that projected increase adds up to $79.20, close to the size of the one-time rebate.

AARP also noted that about 5.1 million beneficiaries paid IRMAA in 2025. People who pay the surcharge this year are shut out of this month’s payment.

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This article was produced with AI assistance and edited for accuracy against the sources linked above.

Image: G. Edward Johnson – CC BY 4.0/Wikimedia Commons