Drug Benefits and Resources

A new payment option that works with a plan’s current drug coverage to help you manage out-of-pocket Medicare Part D drug costs by spreading them across the calendar year (January-December). Starting in 2025, if you select this payment option, each month you’ll continue to pay the plan premium (if there is one), and will get a bill from the health plan to pay for prescription drugs (instead of paying the pharmacy). Even though you won’t pay for drugs at the pharmacy, you will still be responsible for the costs. If you want to know your drug cost before you take it home, you can call the plan or ask the pharmacist at the pharmacy.

There’s no cost to participate in the Medicare Prescription Payment Plan. Participation is voluntary.

This payment option might help you manage monthly expenses, but it doesn’t save money or lower drug costs. 

It depends on your situation. This payment option might help you manage your monthly expenses, but it doesn’t save you money or lower drug costs. You will benefit from participating in the Medicare Prescription Payment Plan if you have high drug costs earlier in the calendar year. Although you can start participating in this payment option at any time in the year, starting earlier (like before September), gives you more months to spread out your drug costs before year ends. Click here to find out if you are likely to benefit from this payment option.

This payment option may not be the best choice for you if:

• Yearly drug costs are low.
• Drug costs are the same each month.
• You don’t want to change how you pay for drugs.
• You are eligible for Extra Help from Medicare.
• You are eligible for a Medicare Savings Program.
• You get help paying for drugs from other organizations, like a State Pharmaceutical Assistance Program (SPAP), a coupon program, or other health coverage.

Download this form and follow the instructions. You can also call 1-888-672-7205. 

Once your health or drug plan reviews your participation request, they’ll send you a letter confirming your participation in the Medicare Prescription Payment Plan.

This is what happens next: 
1. When you get a prescription for a drug covered by Part D, your plan will automatically let the pharmacy know that you’re participating in this payment option, and you won’t pay the pharmacy for the prescription. Even though you won’t pay for your drugs at the pharmacy, you’re still responsible for the costs. If you want to know what your drug will cost before you take it home, call your plan or ask the pharmacist.

2. Each month, your plan will send you a bill with the amount you owe for your prescriptions, when it’s due, and information on how to make a payment. You’ll get a separate bill for your monthly plan premium (if you have one).