💰 The One-Time $90 Medicare Payment Is Coming: Who Qualifies?

If you’ve heard that Medicare beneficiaries are getting a one-time $90 payment, you heard right—but there are some important eligibility rules to understand.

The federal government has announced a one-time $90 Medicare Improvement Fund Premium Rebate for certain Medicare beneficiaries. The payment is intended to help offset the cost of Medicare Part B premiums.

And yes—this is a one-time payment, not a new monthly Medicare benefit.

Who Qualifies for the $90 Payment?

According to the Centers for Medicare & Medicaid Services (CMS), the payment is available to approximately 20.8 million Medicare beneficiaries who meet ALL of the following requirements:

✓ You are enrolled in Original Medicare Part B

✓ You live in the United States

✓ You are not receiving Medicaid assistance that pays your Medicare premiums

✓ You are not paying an Income-Related Monthly Adjustment Amount (IRMAA) on your Medicare Part B premium

What about Medicare Advantage?

This is one of the biggest things to know:

Medicare Advantage (Part C) enrollees are NOT eligible for the $90 payment.

The rebate is specifically for qualifying beneficiaries enrolled in Original Medicare Part B.

So, for example:

Original Medicare + Part B + Medigap:
➡️ Potentially eligible, assuming the other requirements are met.

Original Medicare + Part B + Part D:
➡️ Potentially eligible, assuming the other requirements are met.

Medicare Advantage plan:
➡️ Not eligible.

Medicare + Medicaid paying the Part B premium:
➡️ Not eligible.

Medicare beneficiary paying IRMAA:
➡️ Not eligible.

💵 How Will You Receive the $90?

For most eligible beneficiaries, the payment will be sent by direct deposit.

CMS says most eligible beneficiaries should receive the $90 payment on or around October 8, 2026.

If you don’t have direct deposit, you should receive a paper check mailed to the address Medicare has on file. Some paper checks will arrive later in October.

You don’t need to apply for the payment if you are eligible.

🚨 Be Careful of Medicare Scams

Whenever the government announces money for Medicare beneficiaries, scammers tend to show up.

You should not have to pay someone to receive your $90 payment, and you should be very cautious about anyone asking for your Medicare number, Social Security number, bank information, or a fee in exchange for getting your payment.

If you’re unsure whether you’re eligible or whether a payment you’ve received is legitimate, contact Medicare directly.

CMS says beneficiaries can call 1-800-MEDICARE (1-800-633-4227) to check eligibility. Beginning October 15, 2026, beneficiaries can contact Social Security at 1-800-772-1213 to check the status of their payment.

🩺 What Should You Do?

If you’re enrolled in Medicare, it’s always a good idea to understand which type of Medicare coverage you have and what you’re paying for it.

The $90 payment is a one-time rebate—it doesn’t mean your Medicare coverage or premiums are changing permanently.

And remember, Medicare Advantage and Original Medicare work very differently. Your choice can affect your doctors, prescriptions, premiums, out-of-pocket costs and benefits.

If you have questions about your Medicare coverage, don’t wait until you’re confused by a letter or a change in your plan.

Need help reviewing your Medicare options?

Life and Med: Medicare Resource Center
216 N. 3rd St., Suite B
Leesburg, FL 34748
📞 352-260-0202

Local Medicare help from a local broker—not a call center.

Obamacare Made Easy: 4 Big Reasons ACA Health Insurance Could Be a Great Fit

Health insurance can sometimes feel like trying to read a different language. Deductibles, copays, networks, premiums… where do you even begin?

That’s where the Affordable Care Act (ACA)—often called Obamacare—comes in.

ACA Marketplace plans were created to make health insurance more accessible while providing important consumer protections and potential financial assistance. And with different plan options available, there may be a plan that fits your healthcare needs and budget.

At Life and Med: Medicare Resource Center, we believe shopping for health insurance shouldn’t feel overwhelming. So, let’s break down some of the biggest benefits of ACA coverage in a simple way.

🩺 1. Your Health Comes First

One of the biggest advantages of ACA-compliant health plans is that they are required to cover a set of 10 essential health benefits.

These include:

• Preventive and wellness care — Things like certain screenings, vaccinations, and routine preventive services may be covered without out-of-pocket costs when you use an in-network provider and meet applicable requirements.
• Prescription medications — ACA plans include prescription drug coverage.
• Hospitalization — Coverage for hospital stays, surgeries, and other inpatient care.
• Emergency services — Coverage when you need emergency medical attention.
• Mental health and substance use services — Including behavioral health treatment and counseling.
• Maternity and newborn care — Coverage before, during, and after childbirth.
• Laboratory services — Help with medically necessary testing and diagnostic services.
• Rehabilitative and habilitative services — Services and devices that can help you recover or improve function.
• Pediatric services — Including important healthcare needs for children.
• Outpatient care — Healthcare you receive without being admitted to a hospital.

In other words, ACA plans aren’t just about having an insurance card in your wallet—they’re designed to provide comprehensive healthcare coverage.

🛡️ 2. Pre-Existing Conditions? You’re Protected.

Before the ACA, having a pre-existing health condition could make finding affordable coverage much more difficult.

Today, ACA Marketplace plans generally cannot deny you coverage or charge you more because of a pre-existing condition.

That means conditions such as:

• Diabetes
• Asthma
• Heart disease
• Cancer
• High blood pressure

Don’t automatically mean you have to pay more simply because you have that condition.

The ACA also prohibits annual and lifetime dollar limits on essential health benefits covered by the plan.

And there’s another important protection for families: young adults can generally remain on a parent’s health plan until they turn 26.

That’s one less birthday present to worry about!

💰 3. You May Qualify for Financial Help

Here’s the part many people don’t realize:

You may not have to pay the full price of your Marketplace health insurance.

Depending on your household income and circumstances, you may qualify for financial assistance that can reduce your monthly premium.

There are two major types of assistance to know about:

💵 Premium Tax Credits

Premium tax credits can help lower the amount you pay each month for your health insurance.

The amount of assistance depends on factors such as your household income, household size, and the coverage available to you.

Because eligibility rules and subsidy amounts can change, it’s important to have your current information reviewed rather than assuming you won’t qualify.

💳 Cost-Sharing Reductions

Some people may also qualify for additional savings on healthcare costs when they choose a Silver Marketplace plan.

These savings can potentially reduce things such as:

• Deductibles
• Copayments
• Coinsurance
• Maximum out-of-pocket costs

So don’t automatically assume that the plan with the lowest monthly premium is your best option.

Sometimes, the bigger savings are found in what you pay when you actually use your insurance.

🏥 4. You Have Choices

Not everyone uses healthcare the same way—and your insurance shouldn’t necessarily be one-size-fits-all.

Marketplace plans can come in different network structures, including:

🔵 HMO Plans

Health Maintenance Organizations, or HMOs, typically have a more defined provider network and may require you to choose a primary care provider or obtain referrals for certain specialists.

They can sometimes offer lower premiums in exchange for a more structured network.

🟢 PPO Plans

Preferred Provider Organizations, or PPOs, generally provide more flexibility when choosing healthcare providers.

You can typically see specialists without a referral, and some plans provide out-of-network coverage, although it may cost more.

🟣 EPO Plans

Exclusive Provider Organizations, or EPOs, generally require you to use the plan’s network for covered care, except for emergencies.

The trade-off can sometimes be a lower premium in exchange for a more limited network.

The key is finding the balance between monthly cost, doctors, hospitals, prescriptions, and the flexibility you want.

🔎 What Should You Look At Before Choosing a Plan?

Don’t choose a health plan based on the monthly premium alone.

Before enrolling, take a look at:

✔️ Monthly premium
What will you pay each month?

✔️ Deductible
How much might you have to pay before the plan begins paying for certain services?

✔️ Copays and coinsurance
What will you pay when you visit the doctor, fill a prescription, or receive other care?

✔️ Maximum out-of-pocket amount
What’s the most you could have to pay for covered services during the plan year?

✔️ Doctor and hospital networks
Are your preferred doctors and hospitals included?

✔️ Prescription coverage
Are your medications included on the plan’s formulary?

A plan that looks inexpensive at first glance may not necessarily be the best fit once you consider how you actually use healthcare.

🌴 Florida Health Insurance Doesn’t Have to Be Complicated

Whether you’re self-employed, between jobs, retiring before Medicare, or simply looking for individual or family coverage, the ACA Marketplace may be an option worth exploring.

And if you’re in the Leesburg area, you don’t have to figure it all out by yourself.

At Life and Med: Medicare Resource Center, we help make the health insurance process easier to understand. We’ll help you look at your options, understand the costs, and make sense of the details so you can make an informed decision.

Because healthcare is complicated enough.

Shopping for your coverage shouldn’t be.

❤️ Your Health. Your Coverage. Your Choice.

The right health insurance plan isn’t necessarily the plan with the biggest name or the lowest monthly premium.

It’s the one that makes sense for your healthcare needs, your budget, and your situation.

That’s why taking the time to compare your options can make such a difference.

💗 Have Health Insurance Questions? We’re Here to Help.

You don’t have to navigate the Marketplace alone.

If you’re wondering whether you may qualify for ACA coverage or financial assistance, we’d be happy to help you understand your options.

Life and Med: Medicare Resource Center
📍 216 N. 3rd St., Suite B
Leesburg, FL 34748
📞 352-260-0202

Have questions? Give us a call or stop by our Leesburg office. We’re here to make health insurance easier to understand—one question at a time.

Your Doctor Is Just a Click Away! (Explaining Telehealth)

Telehealth can make getting care easier—but what does Medicare actually cover?

Remember when seeing your doctor meant getting dressed, getting in the car, driving across town, finding a parking spot, and then sitting in a waiting room?

Yeah…that’s a lot of steps just to say, “Hi, Doc!” 😄

Today, many healthcare providers offer telehealth, allowing patients to connect with doctors and other healthcare professionals using a smartphone, tablet, or computer.

But here’s the big question:

Does Medicare pay for telehealth?

The answer is yes, Medicare covers certain telehealth services—but exactly what is covered can depend on your Medicare coverage and the type of service you’re receiving.

At Life and Med: Medicare Resource Center, we’re here to make Medicare easier to understand. So let’s take a look at how telehealth works and what Medicare beneficiaries should know.

💻 What Exactly Is Telehealth?

Telehealth—also called telemedicine, virtual visits, or video visits—is healthcare provided remotely using technology.

Instead of sitting in the doctor’s office, you may be able to talk with your healthcare provider from another location using:

📱 A smartphone
💻 A computer
📲 A tablet
🎥 Two-way video technology
☎️ In some circumstances, other forms of remote communication

Telehealth can be especially convenient when traveling to an appointment is difficult or when an in-person examination isn’t necessary.

⏰ Why Are Seniors Using Telehealth?

One of the biggest advantages is convenience.

A virtual visit may mean:

• Less time spent traveling
• No waiting-room time
• Easier access to certain specialists
• Convenient follow-up appointments
• Easier communication with your healthcare team

And you may be able to continue seeing a provider you’re already familiar with if that provider offers telehealth.

🩺 What Kinds of Care Can Be Done Through Telehealth?

Telehealth isn’t appropriate for every medical situation. Some services require an in-person examination, test, procedure, or imaging.

But certain healthcare services may be available virtually, depending on Medicare’s rules and your plan.

Examples can include:

👩‍⚕️ Primary Care

Virtual appointments may be useful for discussing certain health concerns, follow-ups, medication management, and chronic-condition care.

🧠 Behavioral Health

Medicare covers certain mental and behavioral health services through telehealth, including services provided in the home under current rules.

❤️ Follow-Up Care

Some appointments may be appropriate for virtual follow-up when your provider doesn’t need to perform an in-person examination.

📋 E-Visits & Virtual Check-Ins

Medicare Part B covers certain e-visits and virtual check-ins. These are different types of telehealth services and have specific requirements.

💰 Does Medicare Cover Telehealth?

Yes—but the rules matter.

For Original Medicare, Medicare covers certain telehealth services when the requirements are met.

For many covered Part B services, after you’ve met the Part B deductible, you generally pay 20% of the Medicare-approved amount.

However, telehealth rules changed in 2026.

🚨 A Big 2026 Medicare Update

Beginning January 31, 2026, most Original Medicare telehealth services generally require the patient to be located in a medical facility in a rural area.

There are important exceptions.

For example, certain telehealth services can still be provided when you’re at home, including:

• Mental and behavioral health services
• Certain acute stroke services
• Monthly ESRD visits for home dialysis

Medicare’s rules are detailed and can change, so it’s important to check whether a particular service qualifies.

⭐ What About Medicare Advantage?

Here’s where things can get interesting.

Medicare Advantage plans may offer additional telehealth benefits beyond what Original Medicare covers.

That means two people with Medicare could potentially have different telehealth benefits depending on the coverage they have.

If you have Medicare Advantage, check your plan’s benefit information or contact your plan to find out what’s included.

📱 How Does a Telehealth Appointment Work?

If your doctor offers telehealth, getting started can be pretty simple.

Step 1: Ask Your Doctor

When scheduling your appointment, ask:

“Can this appointment be done through telehealth?”

Step 2: Schedule Your Virtual Visit

Your provider will explain how you’ll connect.

You may receive a link or instructions through your provider’s patient portal, email, or text message.

Step 3: Prepare Your Device

Before your appointment:

🔋 Charge your phone, tablet, or computer
📶 Make sure you have a reliable internet connection
🎧 Use headphones if helpful
💡 Find a quiet, well-lit spot
📱 Make sure your camera and microphone work

Step 4: Click and Connect!

When it’s time for your appointment, follow your provider’s instructions to connect.

And voilà—you’re ready for your virtual visit!

🧓 Can Your Medicare Annual Wellness Visit Be Done Through Telehealth?

Certain Medicare Annual Wellness Visit services may be provided through telehealth when Medicare’s requirements are met.

If you’re interested in a virtual Annual Wellness Visit, ask your healthcare provider whether your visit can be conducted through telehealth and whether Medicare will cover it.

 

📅 Don’t Forget: Medicare Benefits Can Change

Medicare coverage isn’t necessarily set in stone from year to year.

If you have Medicare Advantage, pay attention to your plan’s Annual Notice of Change (ANOC). This document explains changes coming to your plan, including changes to benefits and costs.

And because telehealth rules can change, it’s smart to check your current Medicare coverage rather than relying on something you heard last year—or even last month!

🚨 Before You Click “Join Meeting”…

Telehealth can be incredibly convenient, but not every appointment can be done virtually and not every telehealth service is covered in every situation.

Before scheduling your appointment, ask:

“Is this service covered by my Medicare plan?”

“Will I have an out-of-pocket cost?”

“Can I have this visit from home?”

Those three questions can save you a lot of confusion.

❤️ Healthcare Without the Hassle

Telehealth has changed the way many people access healthcare.

Sometimes you need to see your doctor face-to-face. Other times, a virtual visit may be a convenient option.

The key is knowing what your Medicare coverage actually provides.

At Life and Med: Medicare Resource Center, we believe Medicare shouldn’t feel like trying to solve a technology problem without the Wi-Fi password. 😉

We’re here to help make your Medicare options easier to understand.

❤️ Have Medicare questions? We’re here to help!

Life and Med: Medicare Resource Center
📍 216 N 3rd St, Suite B
Leesburg, FL 34748
📞 352-260-0202

Your local resource for Medicare, health insurance, and life insurance.

Medicare telehealth coverage, eligibility, costs, and location requirements can change. Always verify current coverage with Medicare, your Medicare Advantage plan, and your healthcare provider.

5 Medicare Mistakes That Could Cost You

Medicare can be confusing.

There are enrollment windows, different types of coverage, prescription drug plans, provider networks, income-related costs, and plenty of important dates to keep track of.

And unfortunately, some Medicare mistakes can be expensive.

The good news?

Many common Medicare mistakes can be avoided with a little planning and the right information.

At Life and Med: Medicare Resource Center, we want to make Medicare easier to understand. So let’s look at five common Medicare mistakes—and what you can do to avoid them.

🚨 Mistake #1: Waiting Too Long to Enroll

Turning 65 is exciting.

Medicare paperwork? Not so much. 😅

One of the biggest mistakes people make is assuming they can enroll in Medicare whenever they want without consequences.

Your Initial Enrollment Period generally gives you a seven-month window surrounding your 65th birthday to enroll.

If you don’t enroll in Part B when you’re supposed to and don’t have qualifying coverage through current employment, you could face a late enrollment penalty.

Part D prescription drug coverage has its own late enrollment penalty if you go without creditable prescription drug coverage for a certain period.

💡 How to Avoid It

If you’re approaching 65:

• Know when your Initial Enrollment Period begins and ends.
• Find out whether your current employer coverage affects when you should enroll.
• Don’t assume COBRA or retiree coverage works the same way as active employer coverage.
• Keep documentation about your current health coverage.
• Don’t wait until the last minute to figure everything out.

Turning 65? Start the Medicare conversation early!

🛑 Mistake #2: Choosing a Plan Without Looking at the Details

A plan can look great on paper and still not be the right fit for your particular situation.

Before choosing coverage, look beyond the monthly premium.

Consider:

👩‍⚕️ Your doctors
💊 Your prescriptions
🏥 Your preferred hospitals
💰 Your potential out-of-pocket costs
🌎 Where you live and travel
📋 The plan’s rules and benefits

Medicare Advantage and Original Medicare work differently, so understanding how each option operates is important.

💡 How to Avoid It

Make a list of your:

• Current doctors
• Prescription medications
• Preferred hospitals
• Healthcare needs
• Travel plans
• Expected healthcare expenses

Then compare the coverage—not just the price tag.

🔄 Mistake #3: Choosing a Plan Once and Never Looking at It Again

Here’s a big one:

Your Medicare plan can change.

Even if you loved your plan this year, that doesn’t necessarily mean everything will be exactly the same next year.

Changes can include:

💊 Prescription drug coverage
💰 Premiums
👩‍⚕️ Provider networks
🏥 Copayments and coinsurance
🦷 Dental benefits
👓 Vision benefits
💳 Over-the-counter allowances and other extras

That’s why your Annual Notice of Change (ANOC) is important.

It explains changes to your plan for the upcoming year.

💡 How to Avoid It

When your ANOC arrives, don’t toss it into the “I’ll read that later” pile.

Take a look at:

• What’s changing?
• Are your medications still covered?
• Are your doctors still participating?
• Did your costs change?
• Are the benefits you use still included?

Then compare your options during Medicare’s Annual Enrollment Period if appropriate.

A five-minute review could uncover an important change.

📅 Mistake #4: Missing a Special Enrollment Period

Life doesn’t always follow Medicare’s calendar.

You might retire, move, lose employer coverage, lose Medicaid eligibility, or experience another qualifying life event.

Some of these situations may give you a Special Enrollment Period (SEP) that allows you to make certain Medicare coverage changes outside the normal enrollment periods.

But here’s the catch:

Special Enrollment Periods have rules and deadlines.

💡 How to Avoid It

If something major changes in your life, don’t assume you’ll have to wait until the next Annual Enrollment Period.

Ask:

“Does this life change give me a Special Enrollment Period?”

And if it does, find out exactly when that enrollment window starts and ends.

Keep documentation of important dates, including when employer coverage ends or when you move.

💰 Mistake #5: Forgetting About IRMAA

IRMAA sounds like somebody’s great-aunt.

It’s actually the Income-Related Monthly Adjustment Amount. 😉

IRMAA is an additional amount that some higher-income Medicare beneficiaries pay on top of their standard Part B and Part D premiums.

And here’s the part that surprises many people:

Medicare generally uses tax-return information from two years earlier to determine IRMAA.

So a change in income today may not immediately show up in your Medicare premiums.

💡 How to Avoid Surprises

If you’re approaching retirement or experiencing a major financial change, understand how your income could affect Medicare costs.

Certain life-changing events may allow you to ask Social Security to reconsider an IRMAA determination.

If you believe your income has dropped because of a qualifying life-changing event, you may be able to request a reconsideration.

For complicated tax and retirement-income questions, a qualified financial or tax professional can help you understand your options.

 

✍🏻Medicare Mistake-Proof Checklist

Want to keep things simple?

Before enrolling:

☐ Know your Medicare enrollment dates
☐ Understand your current employer coverage
☐ Make a list of your doctors
☐ Make a list of your medications
☐ Consider your healthcare needs
☐ Think about your budget and potential out-of-pocket costs

After enrolling:

☐ Read your Medicare plan documents
☐ Watch for your Annual Notice of Change
☐ Check prescription coverage each year
☐ Check your doctors and hospitals
☐ Pay attention to enrollment opportunities
☐ Review your coverage when your circumstances change

❤️ Medicare Doesn’t Have to Be a Guessing Game

Medicare may come with a lot of letters, numbers, dates, and fine print—but you don’t have to figure it all out by yourself.

The goal isn’t simply to pick a Medicare plan.

The goal is to understand your coverage and make sure it fits your needs.

At Life and Med: Medicare Resource Center, we’re here to make Medicare easier to understand, whether you’re turning 65, reviewing your current coverage, or dealing with a major life change.

❤️ Have Medicare questions? We’re here to help!

Life and Med: Medicare Resource Center
📍 216 N 3rd St, Suite B
Leesburg, FL 34748
📞 352-260-0202

Your local resource for Medicare, health insurance, and life insurance.

Medicare enrollment rules, costs, penalties, plan benefits, and eligibility requirements can change. Review your specific Medicare information and current plan documents when making coverage decisions.