The $90 Medicare Improvement Fund rebate that began reaching bank accounts around October 8 skipped four groups: people who live outside the United States, Medicare Advantage enrollees, people who pay the income-related surcharge on Part B, and people whose premiums Medicaid helps cover. The Centers for Medicare & Medicaid Services spelled out those limits in a fact sheet dated October 3. It counts 20.8 million people in Original Medicare Part B as eligible.
Who the rebate was written for
CMS describes the payment as a one-time $90 rebate toward Part B premiums. To get it, a person had to be in Original Medicare Part B, live in the United States, receive no premium assistance from Medicaid and pay no Income-Related Monthly Adjustment Amount, the extra charge added to the Part B premium for higher earners and known as IRMAA.
The fact sheet is blunt about the Medicare Advantage group: “Beneficiaries enrolled in Medicare Advantage are not eligible.” It gives no reason for any of the exclusions beyond saying the administration wants to make coverage more affordable,.
When the money was supposed to arrive
Most eligible beneficiaries were set to receive a $90 direct deposit from the Social Security Administration on or around October 8, according to CMS. A letter or email from the President is due in mid-October. A smaller group gets a paper check from the Treasury Department later in the month, marked “Medicare Improvement Fund Payment; $90 Payment to Offset October Premium,” mailed to the address Medicare has on file.
That timing matters for anyone who has seen nothing yet. A person in the eligible group who does not use direct deposit may simply be waiting on the mail. CMS says questions about eligibility or whether a rebate was delivered go to 1-800-MEDICARE (1-800-633-4227), and that Social Security will take payment-status calls at 1-800-772-1213 starting October 15.
For a household sorting out where it landed, the question comes down to which kind of Medicare coverage it holds. Someone in Original Medicare who pays the standard premium, lives in the United States and has no Medicaid help or surcharge is in the group the rebate covers, and a missing deposit by mid-October is a reason to call the numbers above. Someone in a Medicare Advantage plan, abroad, on an income-related premium or receiving Medicaid premium help was outside the rebate from the start, and the useful question for that person is whether any other program lowers the monthly Part B bill.
For anyone left out of the $90, the Part B premium stays at $202.90 a month in 2026 with nothing to offset it. The Medicare Cost & Coverage Protection Kit includes 51 state Medicare cost-help packs that lay out the premium-assistance programs each state runs.
Open the state cost-help pack for the Part B premium →
The premium the rebate was meant to offset
Medicare.gov lists the standard Part B premium at $202.90 a month in 2026, “or higher depending on your income,” with a $283 annual deductible. Set against that, $90 is a single payment worth less than half of one month’s premium. CMS calls the payment one-time.
People who pay the income-related surcharge already owe more than the standard amount, and the rebate left them out. The fact sheet lists no substitute help for any excluded group, so assistance has to come from programs that exist outside the rebate.
Where the money came from
CMS says the rebate is paid from the Medicare Improvement Fund, which Congress created in Section 7002 of the Supplemental Appropriations Act of 2008 to make improvements under the fee-for-service parts of Medicare, Parts A and B. The fact sheet says lawmakers have drawn on the fund about 20 times to offset new spending, including a $20.7 billion withdrawal in 2010 that helped pay for the Affordable Care Act, and it describes President Trump as the first president to use the fund to make Medicare more affordable for enrollees.
The fact sheet does not state a total cost for the rebate program. The only figures it supplies are the $90 amount and the 20.8 million eligible count.
State programs that pay the Part B premium
The main alternative sits at the state level. Medicare.gov describes three Medicare Savings Programs. The Qualified Medicare Beneficiary program pays Part B premiums and also covers deductibles, coinsurance and copayments for Medicare-covered services. The Specified Low-Income Medicare Beneficiary program and the Qualifying Individual program pay the Part B premium only. The Qualifying Individual program requires a new application every year and is first-come, first-served.
The 2026 monthly income limits Medicare.gov lists for a single person are $1,350 for the first program, $1,616 for the second and $1,816 for the third, with a resource limit of $9,950 for a single person. For couples, the page lists $1,824, $2,184 and $2,455 in income and $14,910 in resources. Limits run slightly higher in Alaska and Hawaii, and some states do not count certain income or assets, so Medicare.gov says people should apply even if they believe they are over the line. People who qualify also get Extra Help with prescription drug costs, which the page caps at $12.65 per covered drug in 2026.
Finding out whether a state covers the premium
The route starts with the state, since states run the savings programs. Medicare.gov’s Medicare Savings Programs page sends applicants to Medicaid.gov to find their state’s office, and the same office can say whether Medicaid already covers the premium. The original fact sheet remains the place to confirm the rebate’s own rules, and its phone numbers for 1-800-MEDICARE and Social Security are the quickest check on a payment that has not arrived.
An application usually asks for proof of monthly income, a count of savings and other resources, and the Medicare card. Gathering the latest Social Security benefit letter and a recent bank statement before calling saves a second trip.
CMS’s fact sheet puts the rebate at $90 for 20.8 million Original Medicare enrollees, and Medicare.gov puts the 2026 standard Part B premium at $202.90 a month.
Left out of the $90 rebate, still owing Part B
A Medicare Advantage member, a surcharge payer or a resident abroad gets no rebate, and each of those households still has to work out which help it can apply for. The Medicare Cost & Coverage Protection Kit answers that with 51 state Medicare cost-help packs, so the state programs are in one place.
See your state’s Part B premium help in the Medicare cost-help pack →
This article was produced with AI assistance and edited for accuracy against the sources linked above.
