Medicare Prescription Payment Plan

What is the Medicare Prescription Payment Plan?

The Medicare Prescription Payment Plan is a program that helps you manage your out-of-pocket Medicare Part D drug costs by spreading them across the calendar year (January – December). This program could help if you have high drug costs, especially early in the year.

This is a voluntary payment option offered by all Medicare Part D plans. There’s no cost to opt-in. This program might help you manage your monthly drug costs, but it doesn’t save you money or lower your drug costs.

If you are happy with how you currently pay for your Medicare Part D drugs, your drug costs are low or are the same each month, or if you get help paying for your drugs through other programs such as Extra Help, this payment option might not be the best choice for you.

The prescription drug law caps your out-of-pocket costs at $2,000 in 2025 or $2,100 in 2026. This means you’ll never pay more than the cap for covered Part D drugs in a calendar year. This is true for everyone with Medicare Part D drug coverage, even if you don’t choose to opt-in to this payment option.

How the Medicare Prescription Payment Plan works

• You will continue to pay your Medicare Part D plan premium (if you have one) as you currently do. Always pay your monthly premium first (if you have one), so you don’t lose your drug coverage.
• If your participation is approved, you’ll get a letter with information about how to pay your bill. When a pharmacist submits a claim for your prescription, we will let the pharmacy know that you are part of the Medicare Prescription Payment Plan.
• When you fill a prescription for a drug covered by Medicare Part D, you will get a bill each month instead of paying at the pharmacy (including mail order and specialty pharmacies).
• Your monthly bill will be based on the cost of your prescriptions, plus any previous month’s balance, divided by the number of months left in the year.
• You are responsible for all Medicare Part D out-of-pocket drug costs. If you want to know what a prescription will cost you, call your Medicare Part D drug plan or ask the pharmacist.

How to sign up

• If you are currently participating in the Medicare Prescription Payment Plan and are staying in the same plan for 2026, your plan will automatically renew your participation. You can opt-out at any time by calling 1-833-696-2087, TTY 711.
• If you are changing plans for 2026, your participation will end on 12/31/2025 and you will have to have to opt-in to the Medicare Prescription Payment Plan Program with your new plan.
• You can opt into the Medicare Prescription Payment Plan at any time during the plan year. However, during the Annual Enrollment Period from October 15 – December 7, 2025, you can choose to opt into the Medicare Prescription Payment Plan for either 2025, or for your plan starting on 1/1/2026. You can opt-in at any time in 2026. The Medicare Prescription Payment Plan is not available for SecureBlue^SM members for plan year 2025, but will be available for plan year 2026.
  Note, this program is most helpful for people who have high drug costs early in the year.

To opt-out or leave the Medicare Prescription Payment Plan or to file a complaint or grievance, call
1-833-696-2087, TTY 711

After you opt-out:

• You will continue to receive an invoice each month for the amount you owe until the balance of what you owe through the Medicare Prescription Payment Plan is paid in full.
• You will need to pay your cost share for your prescription drugs at the pharmacy at the time of pick up.