GOOD TO KNOW: You may be eligible for a $250 rebate this year to help with your Medicare drug costs
The Affordable Care Act passed by Congress and signed by President Barack Obama this year contains some important benefits for Medicare beneficiaries.
If you have Medicare prescription drug coverage, and aren’t already receiving Medicare Extra Help, Medicare will automatically send you a one-time $250 rebate check after you reach the coverage gap (also called the “donut hole”) in 2010. This rebate is the first step toward closing the Medicare prescription drug coverage gap.
1. Am I receiving Medicare Extra Help?
You are receiving Medicare Extra Help if you are on Medicaid (Medical Assistance), or if the state pays for your Medicare Part B premium and
you are paying $1.10 for generic medicines and $3.30 for brand name medications. If you have income above 100 percent of the Federal Poverty Level, you may be paying $2.50 for generic meds and $6.30 for brand name medications. If you are receiving Medicare Extra Help, you will not receive a rebate check.
2. 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 out-of-pocket costs for your medications (up to a limit).
3. Will I need to do anything to get this rebate check?
No. There will be no forms to fill out. Medicare will automatically send you 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. Do not 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.
4. When will I get the rebate check?
If you reach the coverage gap this year (in 2010) 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. Mailing of the rebate check will begin in mid-June 2010.
Checks will be mailed monthly throughout the year as beneficiaries enter the coverage gap. However, this is a one-time benefit and beneficiaries who qualify will only receive one check after they reach the coverage gap.
5. What if I don’t get the rebate check when I should?
Beneficiaries who hit the donut hole after the rebate program has begun should expect to receive their 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. You can also check to make sure Social Security has your correct home address. Call 1-899-772-1213 or your local Social Security office. TTY users should call 1-800-325-0778.
If you have any additional questions, you may call Pat Hafermann, elderly benefits specialist with the Aging and Disability Resource Center, at (920) 467-4076.
Resource:
“CMS press release” May 2010
