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$250 Medicare Part D Donut Hole Check

by Ryan Guina

Eligible seniors who are have Medicare Part D plans for their prescription drug costs will be getting some help with the costs of their prescription medications in 2010. As it has become harder for seniors to afford the medications they need, there are finally some initiatives coming to help with cost. The first initiative up is the $250 Donut Hole Rebate Check. But why is it called the ‘donut hole’ check and how will hit help with the costs of prescription drugs?

Medicare Part D Donut Hole – Covering the Gap

What is called the ‘donut hole’ actually refers to the gap in coverage between what Medicare pays and what must be paid out of pocket by Medicare recipients. It is the difference between the cash limits required by the individual plan type where Medicare my pay prescription costs until they rise to a pre-set limit. Once that limit is reached, recipients must take over all payments until the gap once again closes when an upper pre-set limit is reached.

The Donut Hole Check for Medicare Part D is part of the Affordable Care Act initiative which is also working to close the cap in the next 10 years. As a first move towards the goal, Medicare is providing a $250 tax-free rebate check to cover the costs of prescription drugs incurred by the gap.

How the Rebate Works

Qualified senior citizens will automatically receive a check in the mail at the time they reach the coverage gap limit. No one will need to apply for the rebate check. Payments already began in mid-June 2010 and they will continue to be sent out monthly moving forward.

Checks are to be sent out with 45 days of the seniors reaching their coverage gap point. Should an eligible senior not receive a check in the time period should confirm with their drug plan that their status information was sent to Medicare. Checks will only be cut when gap coverage information has been reached and confirmed.

Eligibility for Rebate

To determine eligibility, consult directly with your plan representative as not all seniors are covered under the rebate. For instance, seniors that receive Medicare Extra Help or have private plan benefits are not eligible to receive the $250 check.

Rebate Fraud

Scams relating to the donut hole coverage rebate are on the rise. Seniors are being contacted by con artists under the guise that access to their check can be faster if they provide their banking or credit card information, Medicare identification, and Social Security numbers. The scams will generally result in identity theft as no other party can expedite the access to the rebate check since the process is automated.

What the Future Holds

As the rebate check is a step forward in closing the coverage gap for senior paying for prescriptions, there are other measures in the works. In 2010, qualifying seniors will be receiving a 50% discount on brand name prescription products. Generic drugs will allow for a 7% discount. The gap coverage measures will continue on with the goal to completely close the coverage gap by 2020.


Published or updated October 5, 2010.
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{ 15 comments… read them below or add one }

1 Michael

Regarding the $250 Medicaire rebate, sure every penny helps when your living on a limited, fixed income but the key word here is eligibility, and that unfortunately doesn’t happen untill one has spend between $2000 and $4000 of your own money which when your living on Medicaire and nothing else is like a fortune therefore the $250 rebate in all reality is nothing more than a 6 – 12% one time discount. It cost millions to even put the program together, for 6% off why bother?

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2 Robert E. Miller

I reached the “doughnut hole” by the 30th of April and still have not received the $250 or any correspondence regarding this stimulus. I can not fine any web site where I can obtain status on the subject and I am hopeful that you can help.
Please advise me as soon as possible at the above email address
Thank you, Robert E. Miller

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3 Ryan

Robert, checks start 45 days after you reach the threshold, but since payments didn’t start until mid-June, it may still be a couple weeks. I recommend contacting the Medicare office for case specific information.

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4 Kathleen Hutley

Hello Robert:

First off, I’d say contact your prescription provider company and see if they CONFIRMED to SSA that you qualify. It’s your direct line to “what’s happening?”
Kathleen

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5 Russ

If I have “creditable coverage” through the New York State Health Insurance Program (NYSHIP) and therefore have not joined a Medicare prescription drug plan, am I still eligible for the $250 rebate?

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6 Ryan

Russ, I’m not sure. I recommend contacting the folks at Medicare.

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7 Shirley

Thanks. You answered my Googled question about self cashing the check. Luckily, you were almost at the top of the web sites offered, as the others did not. I’ve put you on my ‘favorites’ list. At 75, good help is not only appreciated, it is needed. Thanks, again.

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8 Samuel Loring Morison

Is there an RX plan that covers the “doughnut hole” in the MedicareRX Plan??? I take 14 drugs & some of them are expensive.

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9 trixie torrz

haven’t recived my check but i hope get soon i take lot medication everyday inusures dosn’t cover it this extra money will helps me for medication that i need
thank god for this i hope get soon

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10 SUE

SINCE APRIL, I’VE BEEN IN THE DONUT HOLE. BECAUSE OF IT BEING A HARDSHIP ON ME, I AM GETTING THREE NAME BRAND MEDS FREE. WILL I STILL BE ABLE TO GET THE $250.00 REBATE?

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11 Kathleen Hutley

I was happy to learn of this site. Turns out, your presc. company has to confirm you qualify or you could wait forever. Don’t bother going to the SSA office. In response to my question they gave me papers to fill out that didn’t apply to where my $250 check was and the equivalent of “not my job.” Charges anyway are ridiculous. My $800 scooter cost $5,000 through Medicare. I’m in the wrong business!!!

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12 connie Garza

I was just wondering if anyone has recieved this rebate check yet? My mother has reached coverage gap point a few months ago, and has not recieved a letter or anything regarding her stimulus check. If anyone has any more information, I would surely appreciate it.

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13 Kathleen Hutley

This is really just an update. I received my $250 rebate check last Friday. This is roughly 2 months after reaching the “donut hole.” I called my prescription insurance company (AARP Complete) and they said my eligibility was confirmed on time and that SSA is overwhelmed by the number of checks they have to send right now and with more people becoming eligible every day, it could be as late as next June before getting more checks to SSA eligible people. It’s interesting that next year there will be no $250 check and I wonder if those people will get any check since it will be 2011? I also learned if a drug goes generic, an instant significant price reduction may not happen for six months or more as I was told by a Wal Mart pharmacist. I hope that info helps. Kathleen

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14 Dean Mueller

Received donut hole rebate 1/22 for my spouse who passed away 12/23.
Due to concerns that SSA has already wiped my checking acct once. Will I or can I deposit the check without recourse.

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15 Ryan

Dean, I’m sorry to hear about your loss. I would contact a tax professional or someone at the Social Security Administration before deciding how to handle this.

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