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Good News For Seniors

Posted on by Karina

Under the Affordable Care Act, seniors who fall into the Medicare prescription drug “donut hole” coverage gap this year will receive a $250 rebate check. An estimated 4 million seniors will see this benefit this year. (Beginning in 2011, there is a 50% discount on brand-name prescription drugs in the donut hole and it’s completely closed by 2020.)

This week, the Department of Health and Human Services (HHS) is sending out the first round of $250 checks to seniors who have fallen into the donut hole. The Administration has announced that it expects to send rebate checks to additional seniors who fall into the donut hole every month or so throughout the rest of the year. CNNMoney.com on the “$250 Medicare checks coming”:

The government is mailing $250 checks this week to seniors who fall into the gap in Medicare’s prescription drug coverage.

The first checks will be sent June 10, three weeks earlier than scheduled, to about 80,000 people. The rebates are the first step in closing the Medicare “donut hole.”

The Department of Health and Human Services estimates that about 4 million seniors will get the rebates in 2010.

“We think our members will see these checks as a good faith down payment on what they’ve been looking for so long: closing this coverage gap,” said Cheryl Matheis, AARP’s senior vice president for health strategy.

“Many Medicare patients are on a fixed income, so every dollar helps,” she added

Medicare beneficiaries don’t have to do anything to receive the check, there are no forms to fill out–Medicare will automatically send a check. Sadly, reports are already coming in about scam artists attempting to defraud seniors. Last month, HHS Secretary Sebelius explained:

…HHS Secretary Kathleen Sebelius warned that scam artists are already taking advantage of the rebate program to circulate bogus ‘application forms’ that solicit personal information such as Medicare numbers.

“If anybody shows up asking for information … report it immediately,” Sebelius said. “Nothing is required in order to get the check.”

Medicare.gov advises:

You don't need to provide any personal information like your Medicare, Social Security, or bank account numbers to get the rebate check. Don't give your personal information to anyone who calls you about the $250 rebate check. Call 1-800-MEDICARE (1″800-633-4227) to report anyone who does this. TTY users should call 1″877″486-2048. Go to stopmedicarefraud.gov to learn more about how Medicare is working with law enforcement to stop scams against seniors.

More frequently asked questions about the benefit from Medicare.gov:

What is the coverage gap and how will I know if I've reached it?
Most Medicare drug plans have a coverage gap. This means that after you and your plan have spent a certain amount of money for covered drugs, you have to pay all costs out-of-pocket for your drugs (up to a limit). The Explanation of Benefits notice, which your drug plan mails to you each month when you fill a prescription, will tell you how much you've spent on covered drugs and whether you've entered the coverage gap.

Will I need to do anything to get this rebate check?
No. There are no forms to fill out. Medicare will automatically send a check that's made out to you. You don't need to provide any personal information like your Medicare, Social Security, or bank account numbers to get the rebate check. Don't give your personal information to anyone who calls you about the $250 rebate check. Call 1-800-MEDICARE (1-800-633-4227) to report anyone who does this. TTY users should call 1-877-486-2048.

When will I get the rebate check?
If you reach the coverage gap this year and enter the Part D “donut hole”, you will receive a one-time $250 rebate check if you are not already receiving Medicare Extra Help. These checks will begin to get mailed to beneficiaries starting in mid-June. Checks will be mailed monthly throughout the year as beneficiaries enter the coverage gap. However, this is a one-time benefit and if you qualify, you will only receive one check after you reach the coverage gap.

Will I have to pay taxes on this rebate check?
No. You don't have to pay taxes on your $250 rebate check. It is tax free.

What if I don't get the rebate check when I should?
If you hit the donut hole after the program has begun, you should expect to receive your check within 45 days. Your rebate may be delayed if Medicare doesn't have information from your Medicare drug plan showing that you reached the coverage gap in time to include you in the next mailing. You should call your Medicare drug plan to make sure all of your information has been sent to Medicare. If you don't get your rebate check, contact Medicare at 1″800″MEDICARE. Individuals receiving Medicare Extra Help will not receive a rebate check. You can also check to make sure Social Security has your correct home address. Call 1-800-772-1213 or your local Social Security office. TTY users should call 1-800-325-0778.

Learn more about how the Affordable Care Act works for Seniors:

Guide for Seniors»

Strengthening Medicare»

Medicare Part D/Closing the Donut Hole»

Curbing Taxpayer Subsidies for Medicare Advantage»

Visit Medicare.gov»

Visit HealthReform.gov»

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