SEATTLE - About one in five people on Medicare in Washington spends enough on prescription drugs to fall into the coverage gap known as the "doughnut hole," the point at which government assistance for their drug costs runs out. Starting this week, some Medicare recipients are getting one-time rebate checks of $250 to help fill that gap. It's part of the health care reform package passed by Congress.

John Hammarlund regional administrator for the Centers for Medicare and Medicaid Services (CMS), says those who receive the checks won't be contacted in advance by anyone from Medicare, and they do not need to do anything in order to qualify for the rebate.

"These checks are going to come automatically, when people enter into the doughnut hole. So, there's nothing that they have to do to notify Medicare."

CMS is warning people not to give out personal information to anyone who claims to be able to help them receive the refund check, and to report such contacts to the state attorney general or to Medicare, at 800-MEDICARE.

Ingrid McDonald, advocacy director for AARP Washington, says $250 doesn't cover much in terms of expensive medications, but it is the first small step in a multi-year plan designed to completely close the doughnut hole by the year 2020.

"There was a lot of political pressure to keep the cost of the overall health care legislation down. So, that's why in the first year, there's really just a good-faith gesture of these $250 rebate checks, to send the message to people that help is on the way."

The rebate is a one-time, tax-free payment, made one to two months after a person's drug costs prompt them to enter the doughnut hole. CMS estimates as many as 150,000 Washington seniors could receive a check this year. Starting next year, prescriptions will be discounted instead, for both brand-name and generic drugs.