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Relief from the Dreaded Doughnut Hole

The new Health Care Reform Act of 2010 gives seniors a big reason to rejoice. The new law contains a provision to help those who have fallen into the dreaded Medicare Part D Doughnut Hole. In 2010 people who get caught in this coverage gap, whether by $1 or more will automatically receive a $250 rebate.

As the new law goes into effect, AARP is concerned about the potential for scams and frauds against seniors. AARP wants to assure seniors that no person will call or write a letter trying to help them get their $250 rebate check. The most important thing to remember about this rebate is that seniors have to DO NOTHING to receive it. There are no forms to fill out, no applications to send in and no telephone questionnaires to answer. Your check will come directly to you in the mail.

Your Medicare Part D plan tracks the amount of money that it pays on your behalf as well as the co-pay that you pay when you purchase your medications. Once you hit the doughnut hole, or $2,830 in total medication cost, you will receive a one time relief payment of $250. Checks will be issued on a quarterly basis and seniors should receive their check during the quarter after they fell into the doughnut hole.

AARP suggests that seniors keep their receipts just in case there could be a problem.

However, next year everything will change. Beginning in 2011 seniors who fall into the doughnut hole will receive a 50% discount on name brand drugs and a 7% discount on generic drugs. Over the course of the next nine years the doughnut hole will incrementally shrink with drug manufacturers and Medicare absorbing 75% of the cost and seniors paying the other 25%.

The new changes that the Health Care Reform legislation brings over the next nine years will significantly help ease the financial burden that seniors endure while in the dreaded doughnut hole. But Virgin Islanders don’t have to wait until they are actually in the Doughnut Hole before taking action to reduce their drug expenses. People who are on Medicare or retired can help themselves by taking advantage of AARP’s on-line Doughnut Hole Calculator. This specialized calculator was developed by AARP and can help you estimate how much you’ll spend on drugs for the year. It can also show you how to delay or avoid falling into the doughnut hole this year by researching less expensive drugs in your plan.

If you still need assistance, contact the VI State Health Insurance Program, VISHIP, a program that functions within the Lt. Governor’s Office that can give you all the facts on Medicare Part D.

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