Why Many Medicare Advantage Enrollees Won't Receive the $90 Part B Payment
A one-time $90 Medicare Part B payment is expected around Oct. 8, but Medicare Advantage enrollees, Medicaid premium recipients, and IRMAA payers are excluded. The article explains that switching to Original Medicare for the payment would not take effect until January and could affect Medigap eligibility.
The $90 comes from the Medicare Improvement Fund, created in 2008 to support Medicare’s fee-for-service program. That origin helps explain why beneficiaries in Medicare Advantage, those whose Part B premiums are covered by Medicaid, and IRMAA payers are excluded.
For 2026, the standard Part B premium is $202.90, up $17.90 from 2025. IRMAA begins above $109,000 for single filers and $218,000 for joint filers, raising the monthly premium to $284.10; about 8% of Part B enrollees pay it. The $90 equals 44% of one standard monthly premium and 3.7% of $2,434.80 in annual premiums.
The one-time payment may leave many Medicare Advantage enrollees, Medicaid premium recipients, and higher-income IRMAA payers feeling excluded, even as they pay Part B premiums. It could prompt some beneficiaries to reconsider their coverage, but the January effective date and possible loss of Medigap eligibility may discourage switches. More broadly, the episode may underscore how Medicare’s eligibility rules and plan choices can create uneven, confusing financial outcomes for older adults.