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Medicare Prescription Payment Program

The Medicare Prescription Payment Program is a new program that makes prescription drugs  more affordable by allowing Medicare members to spread their prescription costs over time.

Passed into law August 2022 by President Biden, H.R. 5376 — Inflation Reduction Act (IRA) includes policies on Medicare drug pricing. The IRA significantly reforms the Medicare Part D benefit design, including a new program, Medicare Prescription Payment Plan (M3P), which will be available to all eligible Medicare members1, beginning January 1, 2025.

Program Overview for Eligible Participating Medicare Members1

  • Financial benefits to all Medicare members1 in 2025 include an elimination of the coverage gap and capping the maximum out-of-pocket (OOP) prescription costs at $2,000 annually which beneficiaries can spread across the plan year.
  • M3P participants will pay $0 at the pharmacy for covered Part D drugs and be billed monthly for any cost-sharing they incur while in the program. Importantly, this will help them manage prescription costs by enabling them to spread their monthly payments over time.
  • Payment might change every month as additional prescriptions are filled.
  • The program is voluntary, and eligible members can choose to opt-in to the program during the annual enrollment period and throughout the plan year. Members can conveniently opt-in via online, by phone, or mail.
  • Existing members will receive additional information in their Annual Notice of Change.
  • New members will receive additional information within 10 days of confirmed enrollment.

1Excludes plans that solely charge $0 cost sharing for Part D covered drugs. See your plan’s Evidence of Coverage for more details.

If you have question regarding the information in this notice, please access the resources on the Centers for Medicare & Medicaid Services Medicare Prescription Payment Plan webpage. You may also contact your local Account Manager.  

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Y0020_WCM_164006E_M Last Updated On: 1/7/2025
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