Third round of Rx 'donut hole' checks in the mail

Affordable Care Act Offers Prescription Drug Cost Relief to
12,942 Medicare Beneficiaries in Arizona

Today, U.S. Department of Health and Human Services Secretary Kathleen Sebelius announced that the third round of one-time, tax-free $250 rebate checks have been mailed to eligible Medicare beneficiaries whose drug costs are so high they have reached the Medicare Part D prescription drug coverage gap known as the “donut hole.”

Experts estimate that more than a quarter of Part D enrollees hit the donut hole and often stop following their drug regimen as a result of the added cost burden. The $250 rebates will go a long way in preventing seniors from having to make such difficult and almost certainly harmful health decisions.

In Arizona, 12,942 seniors and persons with disabilities who rely on Medicare for access to health care have received new help with their prescription drug costs to date, thanks to the Affordable Care Act. Across the country, more than 750,000 Medicare beneficiaries have already received checks this year, and more beneficiaries will be receiving checks in the coming months as they enter the coverage gap.

“High prescription drugs costs are a problem for many seniors and other Medicare enrollees with limited incomes,” said Secretary Sebelius. “These checks are an important first step in helping them afford the medications they need – and are evidence of how Americans are already seeing the very real benefits of the Affordable Care Act. From strengthening the long-term future of Medicare as evidenced by the recent Medicare Trustees report, to saving seniors and the disabled money on everything from prescription drug costs to preventive services, the Affordable Care Act is helping to preserve and protect Medicare.”

The rebate checks will partly close the donut hole this year, with the $250 one-time checks for beneficiaries who enter the gap. In 2011, the Affordable Care Act takes an additional step for Medicare beneficiaries in the donut hole by providing them with a 50 percent discount on their brand name medications. Every year from 2011 to 2020, the Affordable Care Act will take progressive steps to close the donut hole.

In addition to savings on prescription drugs, the new law takes a series of steps to strengthen Medicare. Under the Affordable Care Act:

Medicare beneficiaries will receive free preventive care services like mammograms and certain colon cancer tests and a free annual physical starting in 2011;

By 2018, seniors can expect to save on average almost $200 per year in premiums compared to what they would have paid without the new law, and most beneficiaries will also see a significant reduction in their Medicare coinsurance as a result of the Affordable Care Act; and

The life of the Medicare Trust Fund is extended by 12 years.

“These checks represent just one way that Medicare is going to work better for seniors and persons with disabilities under the Affordable Care Act,” said Don Berwick, administrator for the Centers for Medicare & Medicaid Services. “Seniors will see lower prescription drug costs when they are in the donut hole, preventive services and annual wellness visits without cost-sharing, and higher quality care. And our efforts to crack down on fraud and waste are making beneficiaries safer and Medicare stronger financially, adding years to the Medicare trust funds.”

“Often, seniors reach the donut hole because they are on costly medications to help them manage chronic conditions such as high blood pressure or diabetes,” said Kathy Greenlee, assistant secretary for aging. “These checks will help America’s seniors afford the medications they need to manage those illnesses, keeping them healthy and improving their quality of life.”

Medicare beneficiaries who do not already receive Medicare’s Extra Help receive these checks automatically in the mail when they reach the donut hole; there is no requirement to sign up. Seniors should never give out personal information to anyone who is not a trusted source. Seniors are encouraged to contact 1-800-MEDICARE to report any solicitations of personal information, or go to www.stopmedicarefraud.gov to learn about how the Affordable Care Act helps to protect seniors from scams and safeguard taxpayer dollars.