US — The Trump administration announced a one-time $90 payment to more than 20 million Americans enrolled in Medicare. The payments are intended to help offset the cost of monthly medical insurance premiums for Medicare enrollees. "Because I delivered on this very important issue for the American People, they can also rest assured the highly popular $5,000 Trump Dividend will be distributed to every US citizen if, and when, the Republicans win the Midterm Elections!," he said.

Most eligible seniors will receive the payment via direct deposit in early October. Seniors without direct deposit will receive a check sent to their registered mailing address in early October. The announcement was made on social media late on Friday.

The payments will be funded by the Medicare Improvement Fund. President Donald Trump stated that Congress allocated $2 billion to the Medicare Improvement Fund to improve the Medicare fee-for-service program. "We are finally using this Fund, along with my Most Favored Nations Deals, to substantially LOWER costs for our Seniors," he said.

Medicare Part B enrollees whose premiums are paid by Medicaid or who pay an Income-Related Monthly Adjustment Amount are not eligible for the payment. The MIF payment marks the first time the fund has been used for direct payments to Medicare beneficiaries, despite being established in 2008, per the Congressional Budget Office (CBO).

"I pledged to protect and preserve Medicare and Social Security, which were on the verge of RUIN by Joe Biden, who foolishly and maliciously let tens of millions of Illegal Aliens into our Country, and we are doing just that for America’s Seniors," he said.

In September, he proposed sending $5,000 checks to all adult citizens if Republicans retain control of the House and Senate in the midterm elections. The Republican party holds a narrow majority in both the US Senate and the House of Representatives. The Trump administration is sending $500 payments to nearly 1 million Americans. The administration stated the $500 payments were a refund for excessive fees charged to people who bought health insurance through the Affordable Care Act.

Why It Matters

The use of the Medicare Improvement Fund for direct beneficiary payments represents a shift from its historical application, which previously involved funding other legislative priorities. The fund had $180 million available for services furnished during and after fiscal year 2022, according to the Congressional Budget Office (CBO). The Medicare Improvement Fund (MIF) has been amended 28 times since its 2008 establishment, with 11 increases and 17 decreases to its funding, according to the Congressional Budget Office (CBO).

This distribution occurs alongside other administrative actions regarding healthcare financing and eligibility. Health and Human Services Department published rule titled Patient Protection and Affordable Care Act; Temporary Moratoria on Certain Agent and Broker Registration To Participate in the Exchanges on 2026-09-23. The scale of the payment affects more than 20 million enrollees, marking a federal financial intervention in senior healthcare costs.

Timeline

The Affordable Care Act was enacted in 2010 during the presidency of Barack Obama.

What's New

A study titled "Public Policy and Administration in the Age of Donald Trump" was published in 2022 in Central European Journal of Public Policy. Research titled "Donald Trump Administration" was published in 2019 in When the President Calls. A study titled The Tariff Policy of the Trump Administration was published in 2025 in Nemzet és Biztonság.

Congressional lawmakers historically used the Medicare Improvement Fund to increase healthcare costs, such as the $20.7 billion raid by Democrats in 2010 to finance the Affordable Care Act (ACA), as noted in the White House fact sheet. The Affordable Care Act (ACA) was linked to a $20.7 billion raid of the Medicare Improvement Fund in 2010, as cited in the White House fact sheet, to offset the ACA's costs.