National Commentary

For Many Seniors, Checks Are In the Mail

Starting now, Medicare will be mailing out $250 checks to tens of thousands of Virginians caught in the prescription drug donut hole.

The Medicare ‘donut hole,’ created under the Republican controlled Congress, is the period in the Medicare prescription drug benefit in which the beneficiary pays 100 percent of the cost of the drugs until their payments reach the “catastrophic” coverage threshold. This “donut hole” kicks in when prescription drug costs exceed $2,830. As a result, too many of the hundreds of thousands of seniors in the Commonwealth still find themselves having to choose between getting the prescriptions they need and putting food on the table.

Last year, roughly 91,500 Medicare beneficiaries in Virginia fell in the donut hole and received no extra help to defray the cost of their prescription drugs. But now, under health insurance reform passed by Congress, help is on the way.

Under the recently enacted health reform law, seniors who fall in the donut hole coverage gap in 2010 will receive this one-time tax-free $250 rebate check. These checks will continue to be mailed monthly over the next several months as seniors enter the coverage gap.

Medicare recipients don’t have to do anything to get the $250 check – once their drug costs for the year hit $2,830 the one-time check will be issued automatically. Think of it as a down payment on reduced prescription drug costs for seniors and the first step to eventually closing the donut hole altogether.

Making prescription drugs more affordable for seniors is only one of the many benefits included in the recently enacted health reform law. Here are some other benefits seniors can expect:

Free preventive care services under Medicare, beginning in 2011

Extended solvency of Medicare by an additional 12 years, from 2017 to 2029

Improved access to doctors for seniors Continued reduction of waste, fraud and abuse in Medicare

Greater communication and coordination among doctors, fostering improved patient care

Expanded home and community-based services to keep seniors in their home, instead of in nursing homes.

While a $250 check might not seem like a lot, for seniors across the country it’s the difference between health and sickness, medicine and pain. I look forward to the day when this is not the case-when we’re able to provide basic wellness oriented health care to all of our seniors.

 


Rep. James Moran (D) is Virginia’s 8th Congressional District Representative in the U.S. House of Representatives.