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Doughnut Hole Rebate and Coverage for the Uninsured Available

pharmacist handing man prescription

Jose Luis Pelaez/Getty Images

Since 43,000 Arkansans fell into the Medicare Part D doughnut hole in 2009, they and their family and friends want to know when and how they’ll get the $250 Medicare Part D rebate for 2010.

The answer: About three months after Medicare Part D policyholders and their insurance providers have paid $2,850 for their prescription drug costs this year, the policyholder should receive the $250 rebate by U.S. Mail.

Their insurance provider will know when they reach this point (the Medicare Part D gap in coverage or “doughnut hole”). AARP advises policyholders to keep their prescription drug purchase receipts to help prove their eligibility in case of disputes, and to call your Medicare prescription drug provider, if you have questions.

“Medicare Part D policyholders don’t need to do anything to get the rebate check,” said Maria Reynolds-Diaz, senior state director of the AARP Arkansas state office. “So beware of anyone charging a fee to help get the $250 rebate more quickly, and don’t share any personal information like your Medicare number or bank account numbers with anyone you don’t know well,” Diaz concluded.

Scams should be reported to the Arkansas Attorney General at 501-682-2341.

Nora Super, director of Federal Government Relations at the AARP national office in Washington, D.C. explained to more than 100 people attending the AARP Arkansas health care reform implementation forum in Little Rock on June 17 how the Part D doughnut hole will be closed.

“This year, there’s the $250 rebate for Medicare Part D policyholders. Next year there will be a 50 percent cut on brand name drugs for Medicare Part D policyholders who fall into the doughnut hole, plus a seven percent cut on generic drug prices.”

Provisions under the new health care law will gradually shrink the “doughnut hole” gap in coverage until it is completely eliminated by 2020.

Temporary Pre-Existing Condition Health Coverage Applications Available

The State of Arkansas will receive $46 million from the federal government to provide health insurance coverage to certain Arkansas residents who have been blocked from coverage by private insurers because of their medical history.  This temporary high risk pool program created by the new health law provides a bridge to 2014 when people with pre-existing conditions will have guaranteed access to coverage.  

AARP estimates that 69,393 Arkansans between 50 and 64 are uninsured.  For the first year, enrollment in the state’s new Pre-Existing Condition Insurance Plan (PCIP) will be  limited to 2,500 eligible people in Arkansas on a first-come,  first- served basis. Afterwards, the plan will be reviewed to see if coverage can be extended to more people. Applications will be accepted beginning early August when more information and the application form will be available online at www.chiparkansas.org.

Arkansas already provides a similar risk pool plan to Arkansas residents through the Arkansas Comprehensive Health Insurance Plan (CHIP).  The PCIP and the existing CHIP pool will operate separately, but both will be administered by Blue Advantage Administrators, which is a part of Arkansas Blue Cross and Blue Shield.  

Anyone who has had a problem getting insurance due to a pre-existing medical condition, and who has been uninsured for six months prior to applying for coverage, and who is a U.S. citizen or lawfully present in the U.S.  is eligible to apply for this insurance.  

The PCIP will cover a broad range of health benefits including primary and specialty care, hospital care and prescription drugs. Covered individuals will pay premiums that will range from $156 to $624 per month for a non-tobacco user.  


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