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Don Berwick, M.D., the Administrator of the Centers for Medicare and Medicaid Services, shared a milestone in one of the key steps in the implementation of the new health care reform law.
The $250 rebate checks are the first step towards closing the coverage gap – commonly known as the “donut hole” – in the prescription drug coverage of Medicare. Berwick wrote about how those who hit the coverage gap sometimes change their medication, or skip them altogether, because they cannot afford their medication. Realizing that this is something that may be dangerous and is therefore unacceptable, the Affordable Care Act aims to do away with this gap altogether.
With more than a million rebate checks sent out, it is the hope of the administration that the checks will be able to help the financial burden associated with entering the donut hole – during which time beneficiaries are expected to spend for the full amount of their medication. The checks are sent out, tax-free, without the need to request for them. The checks are mailed once a Medicare beneficiary enters the coverage gap.
Health care reform, however, remains to be a controversial issue. House Republicans opened a week-long focus on their effort to repeal health care reform, on the same day that the announcement regarding the milestone came out. Republicans counter that health care reform will increase, instead of lower, health care costs in the long run, and that it was unconstitutional to force Americans to buy health insurance.
On Tuesday last week, U.S. Department of Health and Human Services Secretary Kathleen Sebelius announced that the third batch of $250 one-time rebate checks have been mailed out to eligible Medicare beneficiaries. This was shared in a press release posted on the website HealthCare.gov.
But what can this $250 check do? According to experts, more than 25 percent of Medicare Part D beneficiaries who hit the prescription drug coverage gap – or “donut hole” – end up discontinuing their drug treatment because they cannot afford the additional cost that they will have to shoulder. These one-time rebates can help keep seniors from choosing to stop medication, a decision that may prove to be harmful to their well-being.
Secretary Sebelius shared: “High prescription drugs costs are a problem for many seniors and other Medicare enrollees with limited incomes… These checks are an important first step in helping them afford the medications they need – and are evidence of how Americans are already seeing the very real benefits of the Affordable Care Act.”
These checks are just the first step towards the closing of the coverage gap, estimated to happen by 2020. Next year, Medicare Part D enrollees will be provided with a 50 percent discount on brand name medications.
Kathy Greenlee, assistant secretary for aging, shared: “Often, seniors reach the donut hole because they are on costly medications to help them manage chronic conditions such as high blood pressure or diabetes… These checks will help America’s seniors afford the medications they need to manage those illnesses, keeping them healthy and improving their quality of life.”
