Beginning on June 15th, beneficiaries who have reached the prescription drug coverage gap ("donut hole") will get a $250 rebate check. In 2010 the “donut hole” is attained at or above $2,830 in Covered Medicare Part D costs. (Exclusions do apply and are explained below).
Those who have reached this point prior to June 1st (and are eligible for the rebate) will receive their $250 rebate check later in June. Beneficiaries who enter the coverage gap after June will be issued the payment based on the quarter in which they hit the coverage gap. In the event that a beneficiary enters the Coverage Gap at the end of a quarter during 2010, the refund may be processed/mailed during the following quarter.
Beneficiaries should be aware that the rebate checks will be processed and issued by HHS, not by their insurance provider, and HHS will issue rebates based on a beneficiary's qualifications at the time that they reach the coverage gap.
Of course there are some who are not eligible and will be excluded from receiving the rebate. Specifically,
- Dual eligible beneficiaries who receive subsidies ("low income subsidy;" LIS) from both Medicare and Medicaid.
- Beneficiaries with annual income exceeding the Part B income thresholds. This means that they have annual adjusted individual income above $85,000 or annual adjusted joint income above $170,000.
- Beneficiaries receiving Retiree Drug Subsidy (RDS)
For those needing assistance selecting a Medicare Supplement Insurance, Medicare Advantage, and/or a Medicare Prescription Drug coverage is advised to contact the Senior Advisors Group at 610-399-8700 or follow any of the links in this article to their website.