Earlier this week President Obama spoke with seniors at a town hall meeting in regards to the Medicare Part D prescription benefit, and talked about how many of those seniors would be receiving a $250 check in the mail as a result of the health care reform passed earlier this year. Today I thought I would explain a bit more about that rebate check being sent out, who will get it, and when they can expect it.
What is the Medicare Doughnut Hole?
One thing that may not have been explained adequately is – just what exactly is the Medicare doughnut hole?
Medicare Part D provides prescription drug benefits to Americans on Medicare. This benefit comes with a $310 deductible. After you’ve spent $310, you pay 25 percent of the cost of your prescriptions until the total cost of all the medicine you have received in a year hits $2,830. Then, you are stuck with 100 percent of the bill until the total cost of your medicines hits $6,440. The gap when Medicare does not cover the cost of your prescription drugs is known as the doughnut hole.
Health reform will close the doughnut hole. Reform also offers immediate relief by providing a $250 rebate this year to seniors who hit the doughnut hole.
According to CBS News White House Correspondent Mark Knoller the checks could start going out as early as this week.
Obama says as more seniors hit the donut hole, more checks will hit the mail – helping 4 million seniors by the end of this year.
So over 4 million checks being sent by the end of the year – that’s a lot of people in the doughnut hole!
Who Will Get A $250 Medicare Donut Hole Check?
Ok, so how do you qualify to get a check? First, you have to be signed up for the Medicare Part D prescription drug benefit. Here’s how it works:
- The prescription drug benefit has a $310 deductible.
- Once the deductible is paid, Part D covers 75% of your benefit up to $2,830.
- After $2,830 in drugs are paid for, you’ll have to pay 100% of your drug costs, up until $6,440.
- After $6440 Part D pays for 100%.
- If you are stuck in the $2,830-$6,440 doughnut hole, you should be receiving a check to help offset the costs.
So if you’re stuck in the doughnut hole you’ll be receiving a small amount of help via the check to help pay for your drugs.
When Are The Checks Being Sent?
The checks are starting to be mailed out this week, and as mentioned above as many as 4 million seniors will receive the check by year’s end.
The $250 checks will be mailed by the Department of the Health and Human Services (HHS), and the HHS logo (see image above) will be clearly displayed on the envelope. It will also include Medicare’s 1-800 toll-free number in case Medicare beneficiaries have any questions. It should be noted that the checks will be mailed by one of Medicare’s contractor. The envelope will include the contractor’s Wisconsin address in case any checks are returned for follow-up.
So if you’re already in the donut hole for the year, keep your eye out for your check in the mail – it should be on it’s way.
Note: There is no need to go through an application process or file anything to receive your check. Once you reach the threshold, the check will be sent automatically.
Medicare Part D Donut Hole Starts Going Away In 2011
The Health Care Reform bill that goes into effect soon made changes that will include closing the donut hole gap.
Among the donut hold changes:
- Beginning in 2011, seniors in the donut hole will receive a 50 percent discount on prescription drugs.
- The Medicare share of costs will increase so that the donut hole will be completely closed in 2020
Stay tuned for further developments!
Are you slated to receive your check this year? Will it make much of a difference for you? How do you feel about the rebate checks? Tell us your thoughts in the comments.
This is reminiscent of the $250 credit social security recipients got last year, which was really just an advance of the social security death benefit their beneficiaries would have gotten anyway. Maybe a rebate in some form will be an annual thing.
The 2009 credit was a lot simpler than this one and there was a lot of confusion over that too. The Medicare credit is so much more complicated–everyone should read this post!
As well intended as it might be, you have to wonder what this rebate, and the subsequent closing of the donut hole will do to the already stratospheric deficit–or if anyone even cares any more…
Peter Anderson says
To some degree it almost just seems that everyone is trying to “get theirs” while they still can, and politicians are handing out small checks to everyone to soothe their fears about the upcoming health care program. For example by many accounts the costs for many seniors under the health care “reform” bill will go up, for many more than $250.. I’m not sure how helpful this $250 will actually be for most people as I was reading a lot of people will never reach the threshold to receive it anyway.
“To some degree it almost just seems that everyone is trying to “get theirs” while they still can” – I think you’re on to something with that thought. If it’s true, all of the goings on in politics and big business start to make sense.
Spread the wealth. Perfect example of our government taking my money and giving it to someone else. Funny thing is our government is broke! They just won’t admit it!
@Financialbondage – oh dear, here it is again the fear of social-ism (perish the thought). Have you thought that eventually someone else might give you his/her money when you’ll be in need? Healthy long life is not a guarantee, you well know this. We live within the bondage of a society. Even if you live in the woods, you still have to connect with the elements that surround you: animals, plants. And how did you reach the conclusion that the government is broke?
Peter Anderson says
He’s not the only one who doesn’t want socialism, trust me. :)
As far as the government being broke, I think he’s referring to the fact that the government is spending with deficits in the trillions of dollars – in other words – spending more than they have. That means they’re essentially broke.
For myself, I’d rather have my money stay with me so I can give to charitable causes – as opposed to trusting the government to spend my money wisely -which they won’t.
We are paying $500 million a day interst on the $13 trillion we owe If that’s not broke I don’t know what is???? the problem is, Obama doesn’t care, he just keep spending. What did you expect from a Chicago mobster, the dictator in the white house!! how many czars have you ever heard of before, this guy makes Jimmy Carter look like George Washington
Peter, I don’t want it either, the only problem is that most people use this word not fully knowing what that means. Anyway, it’s not the point. And frankly, I don’t want to part with my hard-earned money either. But not having reached the stratosphere where the millionaires live and having no hopes to reach that far up … I don’t know. I might have to rely on those medi- whatever will be, will be. I still hope that this country will start producing and using the local work force, and not outsourcing the jobs.
nancy h says
Yes i Received a 250.00 check from s.s. and it says it is a one-time payment under the american recovery and reinvestment act…. I am confused is to what this is … is it different from the part d donut hole that is mentioned.. I am confused can you help thanks nancy
mary colarik says
I HAVE BEEN
Earl and Jeanne Gagnie says
We have gone in the hole since the first of the year. We lost all help we where getting. We have had to either stop some medicines or not eat. Just want to know when we can expect some help. My husband is on Medical. That doesn’t help much. We also have secondary Insurance after Medicare. But it doesn’t cover prescriptions.
Acording to the papers we made out we are over by $8.00.
Jean Whitaker says
My mom reached her donut gap a couple of months ago and as not yet received any stimulus check. Her medication is very costly. Is there anyway to find out if her stimulus has been mailed?
Nora Damon says
$250.00 is nothng towards the cost of some of the drugs and does not even cover one third of the cost of one three months’ supply of one of the expensive meds my husband takes. I hate the way they have made the Part D program so complicated for seniors — I am fortunate enough to be able to comprehend it but I am sure that there are many that cannot. Upon reaching the donut hole the cost of drugs is absurd so we then turn to Canada which has a generic for most of the expensive stuff and brand names at a much lower price. How do the docs think you can possibly afford all of these meds. You pay off your mortgage for your retirement but the cost of drugs is two or threefold what your mortgage was.
Carol Barnes says
I’m in a donut hole, but have Medicare Advantage. Is this still covered? I recently had to pay $935.00 for ONE prescription. Please let me know.
B Hiatt says
My husband has been in the donut hole for 2 months.
Where is the $250? We look for it every day and it isn’t coming.
William Hancy says
I have reached the ” donut hole ” over a month ago and have tried to get some kind of tracking as to where my $ 250 check is. Each call is like riding a different merry-go-round. Nobody knows and nobody cares. I love the comments ” the check is in the mail ” , ” you shoudl receive it in 30 days ” , ” we have no way of tracking who and when someone was paid the $ 250 check, only a DEP will appear on your account ” Now I ALWAYS enter checks as they are written and mark them off when they are cashed at the bank. Am I doing it wrong or is someone else ? If this is the real truth, maybe I’ll wait until I get 2-3 of these checks and then cash them all at once because they don;t have anyway of tracking them. GOOD LUCK !!! OUR GOVERNMENT AT WORK !!
Dan Malloy says
I reached the doughnut hole in the middle of August, 2010. It’s now almost February, 2011 and I haven’t yet received my $250.00 stimulus check. Where is it and when will I be receiving it? I’m tired of getting the run around.
Graham Fisher says
I went in the coverage gap on 9/9/210 and I’m still waiting on my rebate check. I’ve made several calls to Medicare and my insurance company and no one seems to be too sure of what to tell me. The one answer I get a lot is just keep waiting and you’ll get it because it takes months to receive it. It’s a good thing my life didn’t depend on me getting this check. What can I do to get it?
Patricia Clarke says
Never got my $250.00 last year hit the donut hole in Oct. cant find anyone to help or to talk to.