20.8 Million Medicare Beneficiaries Are Getting $90 but Her Advantage Plan Leaves Her Out Despite the Same Part B Premium. Open Enrollment Could Turn the Tide
CMS dropped a one-time payment into millions of Medicare accounts this month, and the rule that determines who qualifies has nothing to do with how much you pay in premiums. Before open enrollment closes, knowing which side of that line…
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The Centers for Medicare & Medicaid Services (CMS) is paying one $90 rebate this month to 20.8 million Americans in Original Medicare Part B. CMS draws a hard line here, leaving Medicare Advantage members out of the payment entirely.
Picture a 68-year-old Medicare Advantage member who hears her neighbor mention a $90 deposit from Medicare. She opens her banking app and finds nothing. Both women pay the same $202.90 standard Part B premium every month in 2026. One choice she made years ago, joining an Advantage plan, cut her out of the rebate entirely. The rebate rule simply never covered her.
Why Her Part B Premium Doesn’t Buy the Same Rebate
The exception traces back to the funding source. Congress created the Medicare Improvement Fund in 2008 to support improvements in Original Medicare’s fee-for-service program under Parts A and B. Medicare Advantage sits outside that system, so paying the Part B premium every month does not make an Advantage member eligible for this rebate.
Original Medicare enrollees can miss out too. CMS limits the rebate to people who:
- Live in the United States
- Receive no Part B premium assistance from Medicaid
- Pay no Income-Related Monthly Adjustment Amount (IRMAA)
For 2026, IRMAA applies above $109,000 of modified adjusted gross income for single filers and $218,000 for joint filers, based on 2024 tax returns. Cross that line by a dollar and you pay the first-tier surcharge of $81.20 a month, for a total Part B premium of $284.10, and you lose the $90. IRMAA touches roughly 8% of Part B enrollees, so most Original Medicare members land on the eligible side (we detailed this and other income-linked surcharges in a free Medicare guide here).
Members should treat the $90 as a one-off. It is meant to offset October’s premium, and November goes right back to the standard $202.90 Part B charge.
Missing Deposit?
Most eligible beneficiaries received direct deposit on or around October 8. Those without direct deposit get a paper check from the Treasury later in October, sent to the address Medicare has on file.
An Advantage member should expect neither. An eligible Original Medicare member who has not received the deposit may simply be waiting on the mail. Two phone numbers sort it out:
- Eligibility questions: call 1-800-MEDICARE (1-800-633-4227).
- Payment status: call SSA at 1-800-772-1213 beginning October 15, 2026.
Switching for $90 Could Cost You Thousands
Per CMS, open enrollment runs October 15 to December 7, and rebate envy could lure Advantage members to switch back to Original Medicare. Run the math first. Without a supplement, Original Medicare carries a $283 Part B deductible, a $1,736 Part A hospital deductible per benefit period, and 20% coinsurance on outpatient care with no annual cap. One hospital admission costs far more than the rebate.
A Medigap policy can cover much of that exposure, but timing works against an Advantage member. The six-month Medigap Open Enrollment Period starts when Part B begins. After that, insurers in most states can review your health history and charge more or decline you unless you qualify for a guaranteed-issue right. A handful of states, including New York and Connecticut, offer broader protections, so check your own state’s rules.
Some Advantage plans also offer a Part B “give-back” benefit that reduces your premium every month of the plan year. A member who wants Part B relief may be able to find it inside Advantage without leaving Medicare Advantage or dealing with Medigap underwriting.
Switch only for durable reasons: specialists outside your network, repeated prior authorization denials, or out-of-state travel your plan won’t cover. If those apply and you can pass underwriting, the move may make sense. The $90 should play no part in that decision.
Three Moves Before December 7
- Confirm your status. If you’re in Original Medicare, live in the United States, fall below the IRMAA threshold and get no Medicaid help with your Part B premium, call SSA if nothing has arrived by late October.
- Re-shop your Advantage plan on full-year cost. Add premiums, the in-network out-of-pocket maximum, your drug costs under the 2027 formulary, and whether your doctors stay in network. Compare plans with a Part B give-back.
- Get a Medigap answer before you drop Advantage. Apply for a Plan G or Plan N quote first. Cancel your Advantage plan only after an insurer approves you.
The $90 is gone, but open enrollment gives her a bigger decision to make. The question now is whether her Advantage plan still earns its place for 2027 once she compares the give-back, network, drug costs and out-of-pocket limit.
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Gerelyn Terzo is the author of dividend investing handbook "Dividend Investing Strategies: How to Have Your Cake & Eat It Too." A veteran financial journalist, she covers agri-finance for outlets like Global AgInvesting and the broader stock market and personal finance for 24/7 Wall Street. She began at CNBC and later helped launch Fox Business in New York. Gerelyn currently resides in Woodland Park, Colorado and dabbles in nature photography as a hobby.
