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If you buy your own health insurance and pay full price, there may be a $500 check with President Donald Trump’s signature headed your way.
The administration began sending the refunds on Wednesday, Sept. 30, according to CBS News. (1) The White House says “nearly 1 million Americans will receive a refund check of $500 per person.” (2)
Trump’s letter to recipients doesn’t mince words: “For years, the Biden administration overcharged you to fund the operation of HealthCare.gov. That money belongs to hard-working Americans, not the Government, and now I’m returning it to you!” (3)
I’ve been a CPA since 1981. Free money is nice, and I’m not going to pretend $500 isn’t real. But it lands at the same time premiums are climbing. KFF estimated marketplace insurers raised premiums 26% on average for 2026 (4), and insurers proposed a median 15% increase for 2027. (5)
So here are six things to know about this check, including one tax wrinkle nobody’s talking about.
1. Who gets one
The refunds go to people who bought marketplace coverage without premium assistance, meaning they paid the full price. (2) Most are people earning above 400% of the federal poverty level. (1)
That describes a lot of early retirees, self-employed people and small-business owners in their 50s and early 60s who aren’t yet on Medicare.
2. Only 30 states are included
The refunds cover 30 states that use HealthCare.gov, including Florida, Texas, North Carolina, Ohio, Michigan and Arizona. (2) Texas alone has about 139,000 recipients, and Florida about 127,900. (6)
If you live in one of the 20 states, or D.C., that run their own marketplace, such as California or New York, you’re left out. (7) So is anyone who received a subsidy.
3. It’s per person, and it may come by mail
Payments go to individuals, not households, so a couple on the same plan could get $1,000. (1) Most recipients should expect a paper check, though an administration official told CBS some families may get direct deposit. (1)
Any time the government sends out money, scammers follow. Nobody legitimate will call, text or email asking for your bank details or a “processing fee” to release your refund.
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4. The tax catch: It may not be tax-free for everyone
The White House fact sheet doesn’t address taxes, and I haven’t seen IRS guidance on this specific refund. (2)
The closest parallel is how the IRS treats premium rebates from insurers. If you didn’t deduct your premiums, the rebate isn’t taxable. If you did, it’s taxable “to the extent that” you got a tax benefit from the deduction. (8)
That’s my read, not an IRS ruling. But if you’re self-employed and took the self-employed health insurance deduction, or you itemized medical expenses, save the letter and ask your tax preparer.
Quick gut-check — if your money advice is coming from random online influencers, you’re playing a dangerous game. I’ve been a CPA since 1981 and writing about money since before the internet existed. Sign up for the free Money Talks Newsletter and get expert advice that’s been tested by time.
5. Put $500 next to your premium increase
KFF estimated benchmark silver premiums in HealthCare.gov states rose 30% for 2026. (4) For 2027, insurers’ proposed increases had a median of 15%. (5)
Here’s a hypothetical. If you pay $1,200 a month, a 15% increase is $180 more a month, or $2,160 a year. Your $500 check covers less than three months of it.
One way to fight back is a high-deductible plan paired with a health savings account, which can cut your premium and your tax bill at the same time.
Lively HSAs charge no monthly account fees, and your balance can be invested for long-term growth. On a high-deductible health plan, not yet on Medicare? Open your free HSA today.
6. Mark your calendar for Nov. 1
Open enrollment for 2027 coverage runs Nov. 1 through Jan. 15. To have new coverage start Jan. 1, you need to pick a plan by Dec. 15. (9)
Don’t auto-renew. Compare every plan, check that your doctors and prescriptions are covered, and see whether your 2027 income could put you under the 400% line, where help with premiums can return.
Critics point out the refunds don’t help people who dropped coverage because they couldn’t afford it, and some question where the authority for the payments comes from. (10) Those debates won’t change your check. They also won’t change your bill.
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The bottom line
If a $500 check shows up, cash it. You paid for it.
Just don’t confuse a one-time refund with a cheaper year of health insurance. Your premium is a bill that comes every month. This check comes once.
Spend 10 minutes now figuring out whether it’s taxable for you, and a few hours in November shopping your plan. That’s where the real money is.
Sources: 1. CBS News; 2. The White House; 3. Daily Caller; 4. KFF; 5. Peterson-KFF Health System Tracker; 6. Newsweek; 7. Money; 8. IRS; 9. HealthCare.gov; 10. LiveNow from Fox
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