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Medicare Question of the Month

Each month, our expert showcases a Medicare question submitted by one of our readers. You may submit a question at any time and get a personal response.

This Month's Question:

  • I heard something about money being sent to people on Medicare this year. Will I get this $250 rebate check?

Answer

  • The rebate check is for people who have such high drug costs that they reach the gap, or “donut hole,” in their Medicare drug coverage. In the gap, they must pay for 100 percent of their drug costs.

  • Not everyone on Medicare gets this rebate. Around 4 million people with Medicare will reach the coverage gap this year and get a rebate check.

  • To get this rebate check, you must meet all of these:

    • You must be in a Medicare Part D prescription drug plan, also called Part D. This is the part of Medicare that helps you pay for your prescription drug coverage costs. Learn more about Part D.

    • You must have reached the coverage gap, or “donut hole,” in your Part D coverage. You must be at the point where you are paying for 100 percent your drug costs. Your Part D plan tells you when you can expect to reach the gap each year. Check your plan’s monthly statements that come in the mail to see when you will reach the gap in 2010.

    • You do not get Extra Help, also called the low-income subsidy (LIS). This program helps people with limited income and savings pay for their Part D drug costs and monthly premiums. People in the Extra Help program already get help with their drug costs in the gap. They do not have a coverage gap. They will not get a rebate check.

  • If you can say yes to all the above, you will get a one-time rebate check after you reach the gap in 2010. Your check should come in the mail 3 to 4 months after you reach the gap. If you have questions about the rebate check, call 1-800-MEDICARE (1-800-633-4227).

  • You can learn more about Extra Help, or get personal help.

Our Expert:

Hilary Dalin
Associate Director, My Medicare Matters
National Council on Aging

Hilary Dalin has worked for many years to enable Medicare beneficiaries to understand their rights by strengthening Medicare beneficiary education and personalized counseling.

At NCOA and in her prior positions, Ms. Dalin has worked with State Health Insurance Assistance Programs (SHIPs), state and local agencies on aging, and other aging network professionals. She has taught elder law at law schools in New York, Connecticut, and Washington, DC.

In addition, she has written and lectured on the following topics:

  • Medicare, Medicaid, and home and community-based care as an alternative to institutionalization
  • The rights of nursing home residents
  • Benefits education and counseling skills.

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