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Closing the prescription drug coverage gap

The Affordable Care Act passed by Congress and signed by President Obama this year contains some important benefits for Medicare recipients.

If you have Medicare prescription drug coverage, and aren't already getting Medicare Extra Help, Medicare will automatically send you a one-time $250 rebate check after you reach the coverage gap - also called the "doughnut hole" in 2010. These checks will be mailed to beneficiaries starting in mid-June, and will be mailed monthly throughout the year as beneficiaries enter the coverage gap.

This rebate is the first step toward closing the coverage gap, but it is a one-time benefit.

Most Medicare drug plans have a coverage gap. This means after you and your plan have spent a certain amount of money for covered drugs, you have to pay all costs out-of-pocket for your drugs up to a limit. The Explanation of Benefits notice, which drug plans mail when a prescription is filled, tell you how much you've spent on covered drugs and whether you've entered the coverage gap.

Beneficiaries who hit the doughnut hole after the program has begun should expect to receive a check within 45 days, but it could be delayed if Medicare doesn't have information from your Medicare drug plan showing you reached the coverage gap in time to include you in the next mailing. You should call your Medicare drug plan to make sure the 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 (800) 772-1213 or your local Social Security office. TTY users should call (800) 325-0778.

There are no forms to fill out to receive the rebate and don't give your personal information to anyone who calls about the rebate check.

In Douglas County, call Pat Nelson, elderly benefit specialist, at (715) 395-1234 or (715) 395-7533 for answers to your questions about this rebate and Medicare Savings Programs that may be able to save you money on your health care costs.

Individuals receiving Medicare Extra Help will not receive a rebate check.