About 35 million people in Medicare Advantage plans are shut out of the one-time $90 Medicare premium rebate that began going out in October, and roughly 12 million low-income older adults and people with disabilities who get premium help through Medicaid are left out too. The payment is reserved for a much smaller group. The Centers for Medicare & Medicaid Services (CMS) says about 20.8 million people qualify.
The rebate is $90 per person, paid once, and the program carries a price tag of about $2 billion, according to the Associated Press. Most payments move by direct deposit. The people left out are not on a waiting list or an appeal track. The exclusions are written into the program’s rules.
Who sits on which side of the line comes down to how a person gets Medicare and whether anyone else already pays the Part B premium. A retiree in an Advantage plan, a person whose state covers the Part B premium, and a higher earner who pays an income-based surcharge are all outside the group. Anyone unsure which category applies can call 1-800-MEDICARE, the line CMS lists for eligibility and delivery questions.
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Who gets the $90, and who does not
CMS describes the payment in a question-and-answer page on the Medicare premium rebate. The agency says the rebate goes to about 20.8 million Americans in Original Medicare Part B who live in the United States, who do not get Medicaid premium assistance and who do not pay the income-related monthly adjustment amount, known as IRMAA.
The same page spells out the exclusions. It says beneficiaries enrolled in Medicare Advantage are not eligible. People who receive Medicaid premium assistance are not eligible. People who pay IRMAA, the extra monthly charge added to Part B premiums for higher incomes, are not eligible either.
How large the excluded groups are
The CMS page gives the size of the eligible group but no count for the people left out. The Associated Press, in its report on the rollout, put the number of Medicare Advantage enrollees who will not receive a payment at roughly 35 million. It reported that 12 million low-income older adults and people with disabilities who get premium assistance will not receive one either, a figure it attributed to KFF, the health policy research group.
Both counts are estimates, and they describe overlapping programs only loosely. They show the scale of the gap. Set side by side, the two excluded groups add up to more than twice the 20.8 million people who qualify.
What officials and critics have said
White House spokeswoman Allison Schuster told the AP that the administration is “enabling Americans to take control of their health.” Juliette Cubanski, who directs KFF’s program on Medicare policy, said the payment “will be automatic,” meaning eligible people do not apply.
Sen. Ron Wyden of Oregon, the top Democrat on the Senate Finance Committee, criticized the plan as a “desperate attempt” by a president, the AP reported. The program has drawn attention mostly for who is outside it. For the 20.8 million inside, the main question is only whether the money has arrived.
When the money moves and where to check
CMS lists direct deposit on or around October 8, an email or letter from the President in mid-October, and some Treasury paper checks later in October. Most people receive a direct deposit through the Social Security Administration. People without direct deposit on file receive a check at the mailing address registered with Medicare.
For payment status, CMS points to the Social Security Administration at 1-800-772-1213, a line it says opened October 15, 2026. Eligibility and delivery questions go to 1-800-MEDICARE (1-800-633-4227). Medicare’s own site, Medicare.gov, shows which kind of coverage a person holds, and the agency’s newsroom posts any later notices about the rebate.
Why Advantage and premium-help households sit outside the rebate
The CMS rules limit the rebate to people in Original Medicare Part B. Enrollment in Medicare Advantage rules a person out, and so does getting Medicaid premium assistance or paying IRMAA.
That leaves a split that surprises people at the mailbox. Two neighbors of the same age, both on Medicare, can land on opposite sides of the line because one chose an Advantage plan. The check status number and the 1-800-MEDICARE line are the two places CMS sends people who see no deposit.
No $90 deposit, and not sure which group applies?
Missing the $90 is a small loss next to the bigger Medicare costs that sit inside the same rules. Premium surcharges, premium help and wrong bills all depend on the same facts that decided who got a payment, and most people never check them.
The Medicare Money Bundle holds all 8 Medicare guides in one download, with large print. Extra Help & Medicare Savings Programs explains who qualifies, what each program pays, and how to apply. IRMAA Appeal Basics walks through Form SSA-44 step by step, with a filled-in sample.
See the Medicare Savings Programs and IRMAA SSA-44 guides behind the $90 rebate exclusions →
This article was produced with AI assistance and edited for accuracy against the sources linked above.
David M. Keller is a finance writer based in Columbus, Ohio, covering personal finance and consumer-focused economic topics. He earned his degree in journalism from Ohio University and began his career reporting on local business and economic trends for a regional media outlet. Since then, he has contributed to a variety of online publications, focusing on clear, practical coverage of topics such as cost of living, debt, and everyday financial decision-making.
