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Medicare Prescription Payment Program

Date: 01/16/25

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.

Mail Express Scripts Medicare

Prescription Payment Plan

P.O. Box 2

St. Louis, MO 63166

  • 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. To access their contact information visit Find My Account Manager.