Medicare Prescription Payment Plan (M3P)

Summary

The Medicare Prescription Payment Plan is a payment option that helps eligible members manage out-of-pocket costs for covered Medicare Part D prescription drugs

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Instead of paying your share of the cost for covered medications at the pharmacy, you can spread those costs into monthly payments throughout the plan year.

The Medicare Prescription Payment Plan does not lower your prescription drug costs. It only changes when you pay them — not how much you owe.

Is the Medicare Prescription Payment Plan Right for You?

This program may be helpful if you have high out-of-pocket prescription drug costs early in the year and would prefer to spread them over the year.

Before enrolling, consider the following:

• If you pay cost-sharing for covered Part D drugs, the program may help you manage those costs through predictable monthly payments.
• If you receive Extra Help (Low-Income Subsidy) or other prescription drug assistance, this program is likely to offer little or no benefit because your drug costs are already reduced. For most members with Extra Help, Extra Help is more advantageous than the Medicare Prescription Payment Plan.
• The program changes when you pay, not the total amount you owe.

Learn About Extra Help →

How the Medicare Prescription Payment Plan Works

When you enroll:

• You don’t pay your share of the cost for covered Part D prescription drugs at the pharmacy.
• Your plan pays the pharmacy on your behalf.
• You receive a monthly bill for the amount you owe.
• Your monthly payment is based on your out-of-pocket drug costs and the number of months remaining in the plan year.

Your monthly payment amount may change during the year if you fill new prescriptions or have additional out-of-pocket drug costs. See the Payment Examples & Calculator to understand exactly how a monthly bill is calculated.

Automatic Renewal

If you’re enrolled in the Medicare Prescription Payment Plan and stay in the same plan, your participation is automatically renewed for the next plan year — you don’t need to reapply. You’ll receive a renewal notice each year, and you can choose to opt out at any time.

Annual Out-of-Pocket Threshold for Part D Drugs

Medicare sets an annual limit on what you pay out of pocket for covered Part D drugs, called the annual out-of-pocket threshold. Once your out-of-pocket costs reach this threshold, your plan generally pays the full cost of covered Part D drugs for the rest of the calendar year. This threshold is set by Medicare and may change each year.

If you’re enrolled in the Medicare Prescription Payment Plan and still have a balance when you reach the threshold, you’ll continue receiving monthly bills until your balance is paid.

How to Leave the Program

You may leave the Medicare Prescription Payment Plan at any time. To opt out, contact Member Services or use the Member Portal.

If you leave the program, any remaining balance for prescription drug costs you’ve already incurred remains your responsibility and will be billed to you.