A one-time $90 Medicare rebate is scheduled for direct deposit on or around October 8. It skips two groups of Original Medicare beneficiaries, and the Centers for Medicare & Medicaid Services describes both through a single test: the payment goes to beneficiaries who don’t receive premium assistance from Medicaid and don’t pay an Income-Related Monthly Adjustment Amount, known as IRMAA. The two exclusions have little else in common. An income figure from a tax return filed more than a year ago places one group, and an application to a state program places the other. Social Security publishes a formal route to revisit only one of them.
A 2024 tax return still sets the 2026 surcharge
The Social Security Administration prices the surcharge from tax data that is already old. For 2026, SSA says it generally uses the most recent federal return the IRS supplies, typically one filed in 2025 for tax year 2024. A beneficiary who retired, married or lost a spouse during 2025 or 2026 can therefore still be charged as though the 2024 income continued. The rebate test inherits that lag: it asks whether a surcharge is being paid, not what income looks like today.
The surcharge begins above a modified adjusted gross income of $109,000 for an individual filer or $218,000 for a married couple filing jointly, according to SSA’s 2026 premium table. In the first tier, Part B costs $81.20 a month on top of the $202.90 standard premium, and the top tier, at $500,000 or more for an individual, adds $487.00. Across a year, the entry-level surcharge alone comes to $974.40, more than ten times the $90 that the CMS rebate FAQ says surcharge payers do not receive.
The question readers will ask next is concrete: does their household fall into either excluded group, and can anything about that placement change? A beneficiary charged the surcharge can compare the income tier against current earnings, since the tiers step at $109,000, $137,000, $171,000 and $205,000 for an individual. A state program decides, through its own approval, who has their Part B premium paid. Only the income-based placement comes with an SSA-published request to revisit it, and that request turns on a life-changing event rather than on a change of mind.
The Retirement Tax & Withdrawal Planner covers the IRMAA appeal route (SSA-44) and an IRMAA tier calculator for checking current income against the brackets above, as optional help alongside SSA’s own request process.
What the SSA-44 life-changing-event request accepts
The SSA-44 form lists the events that count: marriage, divorce or annulment where no joint return will be filed, the death of a spouse, work stoppage or reduced hours for the beneficiary or a spouse, loss of income-producing property (including disasters and investment fraud), loss of pension income through a plan’s scheduled termination or reorganization, and an employer settlement payment. A drop in income with no listed event behind it does not fit the form, which makes the event, not the income level, the gatekeeper.
The form’s instructions add a year rule: the year chosen must be more recent than the year of the tax return SSA used. Income that fell this year points to the current year, while income that fell last year and will not fall further points to the prior year. Evidence is tied to the event, such as a certified death certificate, a certified divorce decree, employer statements or pay stubs, a signed statement under penalty of perjury for work changes, or a letter from a pension fund administrator. SSA returns the originals or an SSA employee views them.
The eligibility wording quoted from the rebate FAQ does not mention the SSA-44 or any reassessment, and SSA describes the request as a way to lower the surcharge rather than to qualify for a payment. The $90 is a single October 2026 deposit, so a request filed now targets the monthly premium, not that deposit. SSA also says a drop in income matters only when it changes the income level the agency considers. A fall that stays inside the same bracket changes nothing.
Medicare Savings Programs and the Medicaid exclusion
Medicaid premium assistance reaches Medicare beneficiaries through the Medicare Savings Programs. Medicare.gov says each state runs these programs, and beneficiaries apply through the state. Three of the four pay the Part B premium: Qualified Medicare Beneficiary, which also covers deductibles, coinsurance and copayments; Specified Low-Income Medicare Beneficiary; and Qualifying Individual. The fourth, Qualified Disabled and Working Individual, pays only the Part A premium. The CMS FAQ names the exclusion as premium assistance from Medicaid without listing programs by name.
The state route is worth far more than the rebate it removes. Twelve months of the $202.90 standard premium comes to $2,434.80, so the excluded $90 is under 4 percent of what a state program covers in a year. Medicare.gov adds that the three Part B programs automatically bring drug-cost help, capping a covered drug at $12.65 in 2026. The federal example income limits begin at $1,350 for an individual and $1,824 for a married couple, though the page says people in some states can qualify above them.
The two exclusions are narrow rather than broad. A beneficiary with income under the $109,000 surcharge line and no state premium help sits in neither group, and the CMS FAQ says most beneficiaries will receive the $90 by direct deposit on or around October 8. Those without direct deposit are due a check mailed to the address registered with Medicare, so the excluded groups are the exception that the payment process is built around.
Asking CMS and SSA which group applies
CMS says beneficiaries can call 1-800-MEDICARE (1-800-633-4227) to check their eligibility for the rebate, and can call SSA at 1-800-772-1213 beginning October 15, 2026 to verify delivery. For the surcharge, SSA’s lower-IRMAA page directs beneficiaries to complete the SSA-44 and fax or mail it with evidence to a Social Security office, or to sign in and submit it online. The state Medicaid office handles the premium-assistance side.
The documents differ by group. A surcharge request needs the tax year SSA used, the year being claimed, and the event evidence the form specifies. A state application turns on that state’s own limits, which Medicare.gov says can run above the federal examples. Neither route needs a paid product, and neither depends on the rebate: the SSA-44 changes a monthly premium, and a Medicare Savings Program changes who pays it.
One comparison remains unresolved: the rebate rule itself decides very little. A surcharge payer forgoes $90 against a surcharge of at least $974.40 a year, and a state-assisted beneficiary forgoes $90 against $2,434.80 of Part B premium that the state already pays. Both exclusions identify an existing status as of the payment date, but only the income-based one is built to be revised afterward, and the published FAQ is silent on whether a revision would reach the rebate.
The Retirement Tax & Withdrawal Planner collects four calculators (provisional income, IRMAA tier, RMD schedule, Roth bracket fill) and the account withdrawal order for readers weighing an SSA-44 request against their income. It is paid, optional, and not an SSA product.
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