Medicare Rebate Checks Closing Prescription Drug Doughnut Hole Mailed

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Government officials said Thursday that $250 checks have just been mailed to about 300,000 people with Medicare to help them pay for prescription drugs in Part D’s infamous coverage gap—the “doughnut hole.”  This is the second wave of tax-free payments to be sent out, going to those who fell into the gap in April, May or June this year. About 80,000 people who hit the gap during the first quarter of the year received their checks last month. By the end of the year, about 4 million people are expected to receive the one-time rebate.   The $250 rebate program is the first benefit of the new health care law to take effect. It’s an early effort by the Obama administration to convince consumers, especially Medicare beneficiaries, that help is on the way, though the main provisions of the law won’t begin until 2014. The amount is small compared with most people’s actual expenses in the gap, when they must currently pay full price after the total cost of their drugs since the beginning of the year reaches $2,830. But the rebate is intended to signal that the doughnut hole—the most unpopular aspect of the Part D drug benefit—will eventually be closed. Next year, people in the gap will see a 50 percent discount on brand-name and biologic drugs and a 7 percent discount on generics. After 2011 the discounts will grow larger until, by 2020, nobody will pay more than 25 percent of the cost of any drugs in what is now the doughnut hole—that is, between reaching the initial coverage limit and qualifying for low-cost catastrophic coverage. “Seniors and other Medicare recipients in the Medicare donut hole are struggling to afford the medications they need and their basic living expenses,” said Kathleen Sebelius, secretary of Health and Human Resources in a statement yesterday. “Seventy percent of our first round of these $250 rebate checks were cashed within a week of eligible Medicare recipients receiving them; so, we know that folks really need some help.” If you’re enrolled in the Part D drug program and expect to fall into the doughnut hole this year, Medicare officials say that this is how the program will work for you:


“Seniors don’t fall victim to scams,” says Congresswoman Johnson. “Some people are calling seniors asking them for their social security numbers and other information in order to receive their rebate checks, this is simply untrue. Seniors have earned their benefits and Congress has a responsibility to deliver them.”                                                                                                                                    ### U.S. Representative Eddie Bernice Johnson is the highest-ranking Texan on the House Committee on Transportation & Infrastructure and a senior member of the Science Committee. She represents the 30th Congressional District of Texas, which, includes Downtown Dallas, Fair Park, Oak Lawn, Turtle Creek, Old East Dallas, Pleasant Grove, & South Oak Cliff; all of Balch Springs, DeSoto, Hutchins, Lancaster & Wilmer and parts of Cedar Hill, Duncanville, Ferris, Glenn Heights and Ovilla.  

Medicare Donut Hole Rebate Checks

Washington, D.C. – Congressman G. K. Butterfield reminds seniors who fall into the Medicare Part D “donut hole” that the one-time, tax-free $250 rebate checks start going out to this week.   “This is an important first step toward closing the Medicare donut hole,” Butterfield said.   Under the Affordable Care Act passed by Congress and signed by President Obama, Medicare will automatically send a $250 check to seniors who reach the coverage gap in 2010. Checks will be mailed monthly staring June 10th throughout the year as beneficiaries enter the coverage gap.   Butterfield said that once a Medicare beneficiary reaches the donut hole, they should expect to automatically receive a check within 45 days. Individuals receiving Medicare Extra Help will not receive a rebate check.   Butterfield warned seniors to be aware of scams seeking personal information.   “Medicare sends check automatically and there are no forms to fill out,” Butterfield said. “Don’t give any personal information – Medicare, Social Security or bank account numbers – to anyone who calls about the rebate check.”   Anyone who does receive calls seeking personal information is encouraged to call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.   Butterfield explained that most Medicare prescription drug plans have a coverage gap, which means that once beneficiaries have spent a certain amount, all drug costs must be paid for out of pocket up to a limit. Medicare drug coverage resumes once the limit is exceeded.   Butterfield said that under the health insurance reforms, the donut hole will eventually be closed completely. Beginning in 2011, beneficiaries in the donut hole will receive a 50 percent discount on brand-name drugs. Additional discounts for brand-name and generic drugs will be phased in to close the donut hole completely by 2020.   A typical senior who hits the donut hole is expected to save over $700 in 2011, and over $3,000 annually by 2020.   Butterfield said that the health insurance reform provided a number of additional improvements to make health care more affordable for seniors. In addition to closing the donut hole, out-of-pocket expenses for preventive services in Medicare have been eliminated, and cost sharing for many individuals dually eligible for Medicare and Medicaid will also be eliminated.

Medicare Rebate Checks Coming to Eligible Seniors

An estimated four million Medicare beneficiaries around the nation will receive a one-time rebate of $250 as part of President Obama’s new health care law to assist seniors who have reached the “doughnut hole.”  Starting next year, beneficiaries will get a 50% discount on name-brand medications once they reach the coverage gap.  According to Health and Human Services Secretary Kathleen Sebelius, the gap will be closed altogether within a decade.

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