President Donald Trump has announced that more than 20 million Medicare beneficiaries will receive a one-time $90 payment intended to help offset the cost of Medicare Part B premiums. The payments will be funded through the Medicare Improvement Fund and are expected to reach eligible recipients during October, ahead of the November 3 midterm elections.
The measure comes as the administration is also distributing separate $500 refunds to nearly 1 million people who purchased health insurance through the Affordable Care Act. Trump has also repeated his pledge to provide a $5,000 payment to adult U.S. citizens if Republicans retain control of both chambers of Congress after the midterms.
Who Will Receive the $90 Medicare Payment
According to a White House fact sheet, the administration will send one-time payments of $90 to more than 20 million people enrolled in Medicare Part B. The Centers for Medicare & Medicaid Services (CMS) said 20.8 million beneficiaries are eligible for the rebate.
Most eligible recipients will receive the payment through direct deposit in early October. Others will receive a paper check from the Treasury Department later in the month. CMS said some beneficiaries receiving direct deposits will later receive an email or letter from Trump.
Not every Part B enrollee qualifies. People whose Part B premiums are already paid by Medicaid are excluded, as are beneficiaries who pay an Income-Related Monthly Adjustment Amount.
The standard Medicare Part B premium in 2026 is $202.90 per month, while the annual deductible is $283, according to the CMS. The $90 payment therefore represents less than half of one standard monthly premium.
The checks will be funded through the Medicare Improvement Fund, which Congress created in 2008 to support improvements to the Medicare fee-for-service program. Trump described the fund in his Truth Social announcement as a “pointless ‘Slush Fund.’”
CMS said Trump is the first president to use the fund for payments of this kind. The agency also acknowledged that Congress has withdrawn money from the fund on multiple occasions to offset other spending.
The payments will reach beneficiaries nationwide. According to a White House breakdown reviewed by USA TODAY, California is expected to have about 1.524 million recipients, followed by Texas with 1.432 million, Florida with 1.398 million, New York with 1.018 million and Pennsylvania with 905,000.
The Announcement Comes Weeks Before the Midterm Elections
The timing places the Medicare payments directly in the final stretch of the midterm campaign. Both direct deposits and mailed checks are expected to reach recipients before the November 3 elections, according to the timetable provided by CMS.
Trump announced the measure while again promoting a separate proposal to send $5,000 payments to adult U.S. citizens if Republicans retain the House and Senate. He said the Medicare payments are separate from that proposal and will not affect the promised “Trump Dividend.”
The administration is also sending $500 refund checks to nearly 1 million Americans in 30 states who bought coverage through the Affordable Care Act exchange. The White House has described those payments as refunds for fees it says were charged excessively to policyholders.
According to The Hill, the Medicare announcement also comes as Trump faces weak public ratings on economic issues. An Associated Press-NORC poll published shortly before the announcement found that 65 percent of Americans blamed Trump’s policies for rising living costs, while 73 percent disapproved of his handling of the economy.
Trump has made other payment proposals during his second term. NBC News reported that he previously pledged a 20 percent return to Americans from savings attributed to DOGE and later discussed a tariff-funded dividend of at least $2,000 per person. Neither payment was distributed.
