Medicare Advantage enrollees are shut out of the $90 Medicare Improvement Fund payment, along with people whose Part B premiums are paid by Medicaid and people billed the income-related monthly adjustment amount, or IRMAA. The Centers for Medicare & Medicaid Services set out all three exclusions in an FAQ dated October 3, 2026, a day after the White House announced the payment but named only two.
The October payment is going to the 20.8 million people CMS counts in Original Medicare Part B who meet its conditions. For an enrollee outside that group, the absence of a deposit is the intended result of the rules, not a missed payment, and each exclusion rests on a different part of how Medicare premiums work.
Medicare Advantage: the exclusion the fact sheet never mentions
The White House fact sheet of October 2 says that most Medicare Part B enrollees are eligible and that those whose premiums are already paid by Medicaid or who pay IRMAA “do not qualify.” Medicare Advantage is not mentioned anywhere in it. The gap is significant because a reader of the fact sheet alone would see only two named exclusions and could reasonably expect a payment.
The CMS FAQ closes that gap. It limits the payment to people in Original Medicare Part B and states that Medicare Advantage enrollees are ineligible. The FAQ also describes the fund’s purpose as improving original fee-for-service Medicare for Parts A and B beneficiaries, which explains why a payment drawn from this fund would stop at the edge of Original Medicare.
Neither source says what share of Part B enrollees are in Medicare Advantage, and no figure for that group is cited in this article. The 20.8 million figure CMS gives is a count of those eligible, not of everyone paying a Part B premium.
Premiums already paid by Medicaid
The second exclusion covers people who receive Medicaid premium assistance. In practice that points to the Medicare Savings Programs, which, according to Medicare.gov, pay Part A and Part B premiums and in some cases deductibles, coinsurance and copayments. Medicare.gov says the programs are run by each state, that applicants contact their state, and that the state decides which program applies.
The logic of the exclusion is that the $90 is meant to offset a premium, and for these enrollees the state is already covering the premium. The CMS FAQ words the condition as not receiving Medicaid premium assistance. The fact sheet words it as premiums “already paid by Medicaid.” Both formulations point to the same group, and neither document lists specific programs by name, so the boundary for someone in a state program with partial coverage is not spelled out in the sources read for this article.
Medicare.gov adds that a state may count income and resources differently from the federal limits, which means the group of people receiving premium help differs from state to state. The payment exclusion follows whoever is receiving that help, not any single income number.
IRMAA payers and the income thresholds behind them
The third exclusion applies to those who pay IRMAA, the extra amount added to Part B and drug-plan premiums for higher-income beneficiaries. The Social Security Administration states that IRMAA applies when modified adjusted gross income exceeds $109,000 for an individual filer or $218,000 for a married couple filing jointly. Its Medicare premiums page lists adjustments from $81.20 to $487.00 a month for Part B on top of the $202.90 standard premium in 2026.
Social Security bases IRMAA on the most recent federal tax return the IRS provides, so the surcharge reflects income from an earlier year, not necessarily current income. A retiree whose income has fallen since that return can ask for a new determination using Form SSA-44, the life-changing event form that Social Security describes on the same page. Whether a successful SSA-44 request would make the person eligible for the $90 is not addressed by the White House fact sheet or the CMS FAQ, and no source read for this article says.
Social Security says it deducts the IRMAA amount from monthly benefit payments, so an affected enrollee may notice the surcharge only as a smaller deposit, not as a labeled line. Neither source says how an enrollee can confirm IRMAA status short of the notice Social Security sends, and a bank statement alone would not show it.
One more condition, and where payment questions go
CMS also lists residence as part of the test: the eligible group lives in the United States. That condition sits alongside the three exclusions above and is stated in the same FAQ answer.
Eligibility questions go to 1-800-MEDICARE (1-800-633-4227), according to CMS. For payment status, the FAQ points to the Social Security Administration at 1-800-772-1213, with the line open to payment-status questions starting October 15, 2026. Deposits by direct deposit are expected around October 8 and checks later in the month, so a person in an excluded group would see nothing in either channel.
The firmest statement in the record is CMS’s own: the rebate goes to people in Original Medicare Part B who live in the United States, do not receive Medicaid premium assistance and do not pay IRMAA, and Medicare Advantage enrollees are ineligible.
Premium support outside the October payment
People left out of the October payment still face the Part B premium, and the programs that pay it work separately. Each runs through a state office, and the limits and application steps differ by state.
The Medicare Cost & Coverage Protection Kit is a 10-page kit that comes with state-by-state Medicare cost-help packs, 51 in all.
Get the state Medicare cost-help packs for Part B premium support →
An AI model helped draft this piece from CMS and White House documents; the figures and dates were rechecked against those pages.
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.
