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) with monthly payments. This program is most helpful for people who have high drug costs 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 out-of-pocket 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 $2,100 in 2026 or $2,400 in 2027. 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 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. This can be online or through the mail.
• When you fill a prescription for a drug covered by Medicare Part D, the pharmacy submits a claim for your prescription. They will be automatically notified that you are part of the Medicare Prescription Payment Plan. You will not pay anything at the pharmacy.
• 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 (see CMS fact sheet for payment examples).
• You are responsible for all out-of-pocket drug costs for your Medicare Part D drugs. If you want to know what a prescription will cost you, check the drug look-up tool in your online member account, 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.
• If you are changing plans for 2027, your participation will end on 12/31/2026 and you will have to have to opt-in to the Medicare Prescription Payment Plan Program with your new plan, using the 2027 options listed above. This is true even if you are staying with Blue Cross Minnesota..
• During the Annual Enrollment Period from October 15 – December 7, 2026, you can choose to opt-in to the Medicare Prescription Payment Plan for either 2026, or for your plan starting on 1/1/2027. You can opt-in at any time in 2027.
  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 the number listed above for the plan year.

After you opt-out:

• You are still responsible for any amount owed through the program.
• 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.