WASHINGTON, D.C. - U.S. Sen. Sherrod Brown (D-OH) and U.S. Rep. Mary Jo Kilroy (OH-15) visited St. Stephen's Community House in Columbus today to outline how the new health care law will provide immediate assistance to an estimated 156,000 Ohio seniors when they reach the "donut hole."
"No senior should have to choose between prescription drugs and food or shelter," Brown said. "The new health care law means that seniors on Medicare will start paying less for prescription drugs and will have better access to physicals, screenings, and other preventive care."
"I am proud to help clean up the broken health care system in part by starting to close the donut hole that forces some seniors make unfair, difficult choices about health care," Kilroy said.
As a result of legislation signed into law by President Bush in 2003, prescription drug benefits to seniors can include a gap in coverage where seniors are forced to pay for drugs out of their own pockets. This benefit comes with a $310 deductible. After you've spent $310, you pay 25 percent of the cost of your prescriptions until the total cost of all the medicine you have received in a year hits $2,830. Then, you are stuck with 100 percent of the bill until the total cost of your medicines hits $6,440. The gap when Medicare does not cover the cost of your prescription drugs is known as the "donut hole." Although private companies offering Medicare Part D coverage may offer plans that do not have a donut hole, 80 percent of plans include this coverage gap.
Eligible Ohio seniors who fall into the donut hole will start receiving $250 checks as soon as Monday thanks to the new health care law, the Patient Protection and Affordable Care Act. Seniors who qualify will automatically receive the checks and do not need to sign up.
Starting next year, Medicare seniors in the donut-hole will receive a 50 percent discount on prescription drugs and coverage will increase until 2020, when 75 percent coverage on all drugs purchased will eliminate the donut hole. Additionally, the Patient Protection and Affordable Care Act will maintain and improve Medicare benefits for seniors by providing seniors with free physicals and low or no-cost preventive services like screenings and colonoscopies. The law includes incentives for care coordination to improve health care quality and to better spend the more than 90 percent of Medicare dollars spent on treating chronic conditions. For more information on how the new health care law improves Medicare, click here.
The $250 checks will be mailed by the Department of Health and Human Services (HHS), and the HHS logo will be clearly displayed on the envelope. It will also include Medicare's 1-800 toll-free number in case Medicare beneficiaries have any questions. No personal information such as Medicare, Social Security, or bank account numbers is required to receive the rebate check. Medicare beneficiaries should not give their personal information to anyone who calls about the $250 rebate check.