Trump Promises $90 Medicare Payments to 20 Million Seniors Before the Midterms

President Trump said late Friday that the federal government will send a one-time payment to roughly 20 million people enrolled in Medicare to help cover their monthly Part B premiums, the latest in a string of cash promises made in the weeks before the November midterm elections.

The Centers for Medicare and Medicaid Services said Saturday that about 20.8 million beneficiaries are eligible for a $90 rebate. In his social media announcement, Mr. Trump described the checks as worth “nearly $100.” Most recipients are expected to get a direct deposit in early October, with paper checks from the Treasury following later in the month, so the money should reach households before the Nov. 3 vote.

The payments will come from the Medicare Improvement Fund, which Congress created in 2008 to strengthen traditional fee-for-service Medicare. Mr. Trump called it a “slush fund.” The fund holds just over $2 billion, according to the health research group KFF. The agency says no president has used the fund to pay beneficiaries directly before, and its own fact sheet notes that Congress has repeatedly drawn the fund down to offset other spending.

Eligibility is narrower than the headline figure suggests. Only people in original Medicare Part B qualify, which leaves out the roughly 35 million people in private Medicare Advantage plans, according to an analysis by the health research group KFF cited by the Associated Press. Low-income seniors whose premiums are already paid through Medicaid, and higher earners who pay an income-based surcharge, are also excluded. By the Associated Press’s count, fewer than a third of all Medicare enrollees will receive a check.

The rebate lands against a backdrop of rising costs. The standard Part B premium climbed to $202.90 a month this year, up from $185 in 2025, an increase of nearly 10 percent, according to the agency’s own figures. A $90 payment covers less than half of one month’s premium.

The announcement follows other pledges. The administration is separately sending $500 checks to about one million people who bought coverage on the Affordable Care Act marketplaces, which the White House describes as refunds of excessive fees. Mr. Trump has also promised $5,000 to every adult citizen if Republicans keep both chambers of Congress, a plan that has drawn skepticism from economists and from some Republican lawmakers and that comes with no explanation of how it would be paid for.

White House spokeswoman Allison Schuster said the rebates return money directly to Medicare patients and help them take control of their health care. Supporters argue that any relief is welcome when older Americans are paying more for food, fuel and premiums, and that the fund was already available for Medicare’s benefit.

Critics see a pre-election maneuver. Senator Ron Wyden of Oregon, the top Democrat on the Finance Committee, called the payments another desperate attempt by a failed president to escape Americans’ disgust with his agenda, the Associated Press reported. Juliette Cubanski, who directs Medicare policy work at KFF, said the money may help some people but might not go very far.