$250 Prescription Drug Rebate Payment For Doughnut Hole Medicaid Gap

by Lance


One of the immediate changes which will result from the historic 2010 health care bill will be a $250 payment to help with prescriptions.  There are quite a few Americans who have a drug coverage gap known as the “doughnut hole”.   This gap in Medicare D Drug benefit program means that assistance from Medicare for different levels of annual drug costs is not consistent through different levels of annual costs.

Right now the following costs (which include drug costs and Medicare payments)  are covered as shown:

  • $0 to $295 – No coverage – patient pays 100% of the costs.
  • $295 to $896.25 – 75% is covered by Medicare.
  • $896.25 to $4,350.25 – nothing is covered by Medicare – This is known as the “doughnut hole“.
  • $4,325.26 and up – 95% covered by Medicare.

Medicare Part D is a program to help subsidize the prescription costs of Americans and has been in place since January 1, 2006.  It was introduced as part of the Medicare Prescription Drug, Improvement and Modernization Act of 2003.

Is this $250 rebate permanent?

No, but the drug companies will be lowering the prices on their brand-name drugs by 50% starting in 2011 and 75% by 2020 which will completely close the doughnut hole so this rebate won’t be needed anymore.

How do I claim my $250 prescription payment?

If you are eligible for the tax free $250 rebate, then Medicare will automatically send it to you.  You don’t need to do anything.  No forms, no phone calls – nothing!

When will I get the $250 rebate check?

The $250 checks will begin to get mailed starting in mid-June of 2010.  You only get a check if you are in the “doughnut hole” coverage gap.  The checks will be mailed throughout the year, but only to new people who have reached the coverage gap.  You can only get a maximum of $250 and no more.

$250 Drug Rebate Scams

Please be aware that there are people who are trying to scam seniors into handing over their personal information by telling them it’s necessary to get the rebate.  This is not true.  Nobody should call you about the rebate – if they do, then don’t give them any information at all.

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