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Medicare Checks For Drug ‘Doughnut Hole’ Coming Soon

Posted May 29 2010 11:48am

Julie Rovner - NPR’s Health Blog

There’s nothing a politician likes to say more than “the check is in the mail.” And today, that’s what Health and Human Services Secretary Kathleen Sebelius got to tell many people who get their medicines through Medicare.

Well, the checks are almost in the mail. The checks in question are the $250 “rebates” that will go to Medicare beneficiaries who fall into the notorious “doughnut hole.” That’s the gap in coverage after you use the first roughly $2,500 worth of drug benefits, but before you spend $4,500 out of your own pocket on medications.

What Sebelius announced was that the first batch of checks will go to some 80,000 seniors who have already fallen into the doughnut hole early next month around June 10. Checks will then go out every 30 days or so after that. By year’s end, an estimated four million beneficiaries will get them.

The rebates are a one-time benefit. Starting next year, beneficiaries will get a 50 percent discount on brand-name medications once they reach the coverage gap. Within a decade the gap will be closed altogether.

At a news conference on implementation efforts on the new health law, however, Sebelius warned that seniors not only need to do nothing in order to receive the rebate checks they SHOULD do nothing. “Their billing history will be monitored…and they will automatically get the check,” she said.

In fact, she added, if anyone shows up at a Medicare beneficiary’s door, asking for Medicare information, or a signature, or other personal information, “not only don’t give it, but report that immediately, because we’re very worried about the fact that we already have reports in some jurisdictions around the country that scam artists are doing just that.”

Julie Rovner - NPR’s Health Blog

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