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$250 Medicare Donut Hole Checks

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Department of Health and Human Services LogoThis week, the first batch of $250 Medicare Donut Hole Checks will be mailed out to the estimated 4 million eligible Medicare recipients. If you’re set to receive a $250 donut hole check, you don’t have to do anything. Don’t listen to anyone who tells you otherwise, you will receive your check automatically when it’s time.

The check will be sent out by the Department of Health and Human Services and the HHS logo (shown to the right) will be prominently displayed. The letter itself will be mailed from a Wisconsin address from one of the HHS’ Medicare contractors.

Who will receive these checks? People on Medicare who have exceed $2,830 in drug costs this year and find themselves in the Medicare donut hole. The Medicare Part D prescription drug coverage works out like this for 2010:

  • $310 deductible, after which,
  • It pays 75% of prescription costs up to $2,830, and,
  • 100% of costs above $6,440.

Between $2830 and $6440, Medicare pays nothing. It’s called the Medicare Part D prescription donut hole and it was fixed by the health reform bill passed earlier this year, but that fix won’t be implemented until 2011.

For now, the $250 payment is a bit of help to those who are in that donut hole. It doesn’t plug the hole but it does provide some relief.

There are more answers in this FAQ at HHS.

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50 Responses to “$250 Medicare Donut Hole Checks”

  1. Shirley says:

    Jim, Thanks for the very clear and concise explanation of what this $250 Medicare Donut Hole Check is for, who gets it and when, and the requirements. There has certainly been a lot of misunderstanding about it.

    • Joe Burch says:

      Jim: how does the Dept of Health and Services know whe I reach the doughnut hole? Do they access to our bank info, tax files and medical files?

      Joe Burch

      • Jim says:

        I believe that when you make claims or use your Part D coverage, it sends information to them about where you are in the schedule. They wouldn’t access (or need to access) any of that information, it would just be based on your claims.

        • Shirley says:

          Also be aware that this reporting concerns only those things that are claimed and covered by the insurance. Vitamins, supplements, over-the-counter meds and health or safety needs do not count toward your deductible or the donut hole.

      • WILLIE says:

        If you are in a Plan they will submit the information to the right people and then we have to wait and wait until the computer feeds it out, so the checks can be printed out.

  2. CreditShout says:

    This is a great explanation of what many people would probably misunderstand. I agree that although $250 dollars isn’t an overwhelming figure, it will still help those who spend a great deal of money on medical care each year. Any amount will help these people.

  3. billsnider says:

    Congress enacted a plan to give basic coverage to all and goodcoverage for extremely ailing people. They wanted to limit this paln, thus the doughnut hole.

    Now they say this is bad and changed it by filling in the hole.

    Says a lot about their thinking.

    Bill Snider

    • Shirley says:

      It also makes me wonder where they came up with the figure of $4,627.50 (310. + 707.50 + 3610.) out-of-pocket cost for drugs each year to begin with.

  4. Well, $250 may not seem overwhelming to someone who’s on a salary, but if I had to pony up that much for prescription drugs, it would break my bank. Let’s remember: Medicare isn’t cheap. For Medicare Part B, Medicare Part D, and Medigap insurance I’m paying six times what I paid for an employer-sponsored plan that covered my drugs with no gigantic gap. That’s while I’m trying to live on a third of what I earned before I was laid off.

  5. zapeta says:

    I wish they’d send me $250 to spend on donut holes! :P

  6. eric says:

    Thanks for the explanation. I didn’t get it when I was reading other news sites.

  7. Peggy Smith says:

    I don’t understand the Doughnut Hole. I am not 65. I’m on permanent disability, I have 17 different prescriptions. Some of my medications are around $1000.. I cannot pay for for my medicatios with this plan. Why did you send me this $250. check? I have the Medicare Advantage Plan part D Drug Plan. Explain this to me, so I can understand this “doughnut hole”.Do I have a choice in the matter, without being penalized?

  8. Anonymous says:

    I was told by Medicare that even tho I am in the donut hole and have been paying over $150 a month for 3 months of prescriptions, that I am not eligible for the money as part of my premium for part d is paid by Medicare. Do you know about this? I am quite upset as I don’t have 150 dollars a month for my scripts

  9. J.P. says:

    Do I recieve a check if I am on medicare part D. I also have medicaid through the state. Or does the medicaid program restrict me from recieving the $250.00?

  10. Bob says:

    Keep in mind how this works. You look at all the companies your drugs to get the best deal. My wife takes Nexium and we fond a company that would provide it for about $180 for three months. The problem comes in that when they calculate the donut hole they also calculate what your insurance company pays. So, instead of the $180 for three months it was really $1000. That with her other drugs she will max out in June and have to pay 100% of her perscriptions plus the insurance premium until the prescription costs exceed $4870?? Also, our taxable gross is too much for the AstraZeneca Savings card. I guess that means “Hello Canada”. You can buy Nexium there for about $180 for 180 pills.

    • Judi says:

      Did you take to your pharmacy people about generic or even OTC? My husband takes OTC Omeprazole & it is the only thing that helps his stomach.

  11. mary ann schulke says:

    It’s very interesting to come up with giving us $250.00. I would love to see Obama and our congress people live like this. We pay their salaries and they send us a token. i do appreciate the 250.00 now, if that would be for every month it would be great-now it’s still food or meds-but we can afford to send money all around the world. Europe should see some of our poor areas here in America-we don’t all live like the pres and his gang.my cousin got 250 last year and at income tax time had to give it back to Obama.

  12. Michael says:

    250$ is a drop in the bucket. In one sweep he increases the costs, in another move, he gives out a fraction of what he already took. It would be like me taking 3 dollars from you, then me “giving” back 1 dollar and expecting you to be excited about it. Lol

  13. bev says:

    I have received the donut hole but haven’t received a check yet. I see they are sending them out on june10th . I have received no letter stating I am getting one but have called a while ago and do realize I have been in the donut hole for a while. Why haven’t I received the check of 250.00 For those stating its only 250.00 = 250.00 is better than nothing. I am grateful for what I get to help me with meds.

  14. dm says:

    i have medicare and medicaid—-do i still get the 250.00? when? what month?
    is there a number i can call to find out if i will get it or not?

  15. Liz says:

    Good grief, we that are on SSI SS and live day to day, may not be the ones who get this check. I dont understand why . Again the government kicks us in the ass.

  16. Mario says:

    We have a medicare advantage insurance plan with Anthem BC & BS….Are we elegible for the $250.? We have 18 prescriptions and are in the donut hole. HELP!!!!!!

  17. grace kelly says:

    I reached the MC doughnut hole in Dec. 2009 and paid a lot in dec. for drugs. Am I entitled to 250.00 dollars in 2010?

  18. eleanor says:

    I have been in te do nut hole since April. Why have I not received a check as of July 14, 2010?

    • ME TOO says:

      I’m with you Eleanor! I too have been in the insurance “gap” or “hole” since May-June and have also heard the rumors of the $250.00.
      I say rumors, because as of right now that is all it is to me or any one that I have ever spoken with. FICTION, when are they coming, I’ve needed it ALL YEAR! I didn’t wait for them to “magicaly” find out either, I called, SSA and AARP and informed them. Still it’s just another one of Obama’s LIES!

  19. The drug companies are still in control all they do is raise the cost of the medication to get us in the donut hole sooner.

  20. Lourdes says:

    As always, the very poor stay poor. Why didn’t you just give the money to the banks? They could have used it on vacations and lofty living. It is time to stop the suffering of the very poor in this country. They need decent housing, get rid of the slum lords, they need enough money to actually “live”. We are the walking dead.Get rid of all the welfare workers they don’t do much anyway. Use computers. It is our fault that we are disabled. I think that communism must be better. At least most of the people would be on even ground.

  21. Marshall says:

    I have been paying full price for my medicine since the end of April. My last bill was over $1,000 and I have yet to receive a $250 check. So much for help.

  22. Charlotte says:

    Can anyone tell me if some one is on medicaid if they will get the 250.00 this yr 2010. thank you.

  23. I HAVE BEEN IN THE DONUT HOLE SINCE MAY AND I HAVEN’T RECEIVED THE $250.00 CHECK YET CAN YOU TELL ME WHEN IT WILL BE MAILED

  24. Rodger Epley says:

    I have hit the do-nut hole last month and no one knows where to go to check on the $250.00. Is is possible to see if my name is one the list or is it just a wait and see? Thanks for your help!

  25. pat martin says:

    This is a disgrace to the seniors of this our US of America…. Please be aware that our elected officials in Wash. DC do not have to deal with health care RX rules that we do in everyday America… How can they call our senior age our “Golden Years “?? Obama, listen to your elders,we need respect,and we in the DONUT HOLE need help, thanks for the $250.00 but lets be real that is a joke…


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