Thousands of Montanans using Medicare's Part D prescription drug plan should be receiving rebate checks by mail soon, said a Medicare official touring the state to talk about changes to the federal program.

Nearly 20,000 people who fall through the gap in Medicare prescription drug coverage should receive $250 rebate checks, issued by the federal government as part of the health care overhaul, Mike Fierberg, spokesman for the Centers for Medicare and Medicaid Services Rocky Mountain Region, said Tuesday.

There are about 165,000 Medicare Part D users in Montana.

Those who qualify for the rebates will fall into the coverage gap known as the "doughnut" hole before Dec. 31 of this year. The doughnut hole refers to the point when patients amass $2,830 worth of prescription drug expenses this year, lose all federal aid and are responsible for the total out-of-pocket cost.

Catastrophic coverage resumes when someone has reached $6,200 in total prescription costs, at which point Medicare pays about 95 percent of the total. The doughnut hole is the $3,400 gap between regular and catastrophic coverage.

The one-time rebate is meant to help seniors with their prescription costs through 2010, Fierberg said. In accordance with the Patient Protection and Affordable Care Act, passed by Congress last March, the government will replace the rebate checks with a 50 percent discount on selected brand-name drugs in January 2011.

"That's much more valuable than a $250 check," Fierberg said.

Under the new law, the discounts will increase gradually until the coverage gap no longer exists, probably in 2020, Fierberg said.

The rebates will be mailed automatically to those who fall into the coverage gap this year. It takes about 45 days to receive the check after the $2,830 threshold is crossed, he said. The first checks for those who qualified by June 30 should have been received by Aug. 14.

The next round of checks will come out sometime after Labor Day.

Fierberg advised people to be wary of scams that ask for personal information to get the rebate. Anyone with questions should call 1-800-633-4227, the national Medicare number.

Fierberg also said that since many people, including seniors, are unsure of exactly what's in the health care overhaul, his agency is working to inform people how the bill will affect them. One of the major concerns he's heard is that Medicare Advantage program, made up of health plan options approved by Medicare but run by private companies, will be cut under the new law.

"The notion that Medicare Advantage is going away is not true," he said. "We do not anticipate changes in most Advantage plans."

Peggy Tombre with the Area IV Agency on Aging said she visited all of the senior centers in Gallatin and Park counties in June to let people know about the upcoming rebate checks. She said she hasn't received much feedback from people who have received the checks or who are facing changes to their plans, some of which won't take effect for several years.

"It will probably take a while before people actually experience changes personally," she said.

Upcoming changes people should be aware of include the signup for Medicare Part D and the Medicare Advantage program. The signup period for both programs begins Nov. 15 and continues through Dec. 31. This year, people may no longer enroll in Medicare Advantage after Dec. 31.

People may drop their Medicare Advantage plan until Feb. 15.

The Montana State Health Insurance Assistance Program is available to help Medicare beneficiaries and their families or caregivers. SHIP is operated through the state's Area Agencies on Aging and can be reached at 1-800-551-3191.

Lauren Russell can be reached at lrussell@dailychronicle.com or 582-2635.

© 2012 The Bozeman Daily Chronicle. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.