Medicare Watch

Closure of the Doughnut Hole Begins Today

Today, the Department of Health and Human Services (HHS) will begin sending the $250 rebate checks to consumers in the Medicare drug coverage gap, also known as the “doughnut hole.” This rebate is a result of provisions included in the health reform law. HHS will send an estimated 80,000 checks today to people who have entered the coverage gap since the start of 2010, and will continue to send the rebates on a rolling basis approximately every month to people who newly enter the doughnut hole.

The rebate checks will be sent automatically and there are no forms to fill out. Consumers should protect themselves from fraud, and should not provide personal information, such as Social Security numbers or bank account numbers, to anyone who contacts them about the rebate. People should report potential fraud by calling 1-800-MEDICARE.

The health reform law gradually phases out the doughnut hole. This year, people who enter the coverage gap will receive the one-time $250 rebate check. Beginning next year, consumers in the doughnut hole will receive a 50 percent discount on brand-name drugs and a 7 percent discount on generics. The share consumers pay for both brand-name and generic drugs will decrease until the gap is eliminated in 2020, when consumers will pay the standard 25 percent of the costs for drugs while in the doughnut hole.

Read Medicare Right Center’s fact sheet: Health Reform and Medicare: The $250 Doughnut Hole Rebate.

Read a statement by Medicare Rights President Joe Baker.

President Speaks to Older Americans about Health Reform

On June 8, President Barack Obama met with older Americans from around the country to answer questions about the new health care reform law.

The President addressed improvements to current Medicare benefits. The health reform law phases out the coverage gap, or “doughnut hole,” over the next 10 years (see article above). Preventive services, such as mammograms, will be free to Medicare consumers beginning next year.

President Obama also answered questions about changes to Medicare Advantage. By 2014, Medicare Advantage plans must spend 85 percent of taxpayer money on health benefits, rather than on administrative costs and profits. While there are cuts in overpayments to Medicare Advantage plans, which will bring the costs of the Medicare Advantage program in line with that of Original Medicare, there will be no cuts to guaranteed Medicare benefits. Plans are still required to provide coverage that is at least as good as Original Medicare.

Watch the town hall or read the transcript.

The Medicare Rights Center was one of several organizations representing older Americans that participated in the town hall meeting. Read Medicare Rights Center’s press release about the event.

Medicare Reminder

If you recognize Medicare fraud, you can call Medicare at 800-MEDICARE (800-633-4227) or the Inspector General’s fraud hotline at 800-HHS-TIPS (800-447-8477). When it investigates the potential fraud, Medicare will not use your name if you do not want it to.

Learn more about Medicare fraud and abuse on Medicare Interactive, the Medicare Rights Center’s free online counseling tool.

Spotlight

The Senate still has not voted to prevent the 21 percent cut in Medicare payments to doctors from becoming permanent this year. These cuts, if they are allowed to take place, could prevent people with Medicare from being able to access their doctors. Contact your senators and ask them to stop the payment cuts.