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Affordable Care Act Begins Filling the Medicare "Doughnut Hole"

Seniors in the coverage gap will receive a $250 check to assist with drug costs

June 10, 2010

WASHINGTON, D.C. - Today, seniors will begin receiving a little extra help with their prescription drug costs as part of the new health care reform law's efforts to close the Medicare "doughnut hole." The doughnut hole is the gap in prescription drug coverage that makes it difficult for many seniors to make ends meet. The doughnut hole will be eliminated by 2020, but in the meantime many seniors will be given some extra assistance with their uncovered medicine costs. Beginning today, Medicare patients who have already fallen into the doughnut hole will receive a $250 check to help them pay for their medications. In 2009, 82,000 seniors in Missouri reached the doughnut hole and experienced a gap in coverage.

"With the passage of health reform, we will close the doughnut hole in a matter of years, but we are also acting to help those stuck in it right now," McCaskill said. "The new assistance going to these seniors might not cover everything, but I hope it will lighten the burden as we finish implementing the permanent changes to Medicare Part D that will finally close the gap."

What seniors need to know:
• The first checks will be mailed today, June 10, 2010.
• Checks will only go to seniors who have already fallen into the doughnut hole.
• Checks will continue to go out monthly as beneficiaries enter the coverage gap.
• The checks are tax-free and seniors do not need to take any action in order to receive their check. Medicare will automatically mail a check when a senior reaches the doughnut hole.
• Seniors should expect their check in the mail within 45 days of hitting the coverage gap.

Because of the new health reform law, additional help with prescription drug costs is on the way as well. Beginning in 2011, seniors will receive a 50 percent discount on brand-name medications when they are in the doughnut hole. Every year afterwards the doughnut hole will be shrunk until 2020 when seniors will have 75% of the cost of their drugs covered from the first dollar all the way to the catastrophic limit thus eliminating any coverage gap.

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