Will this payment option help me?
The Medicare Prescription Payment Plan is a new payment option in the prescription drug law that works with your current drug coverage to help you manage your out-of-pocket costs for drugs covered by your plan by spreading them across the calendar year (January–December).
This payment option might help you manage your expenses, but it doesn’t save you money or lower your drug costs.
Answer a few questions to find out if this payment option will help you
¿Recibe ayuda para pagar los costos de sus medicamentos?
¿Recibe ayuda para pagar los costos de sus medicamentos?
Is your annual income less than $22,590 for a single person, or less than $30,660 if you’re married?
How would you describe your drug costs each month?
Are your total out-of-pocket drug costs for the year usually more than $2,000?
When do you think you'll hit the $2000 max-out-of-pocket for 2025?
Your answer:
This payment option probably won’t help you.
Anyone with a Medicare drug plan or a Medicare health plan with drug coverage can use this payment option, but it doesn’t save you money or lower your costs. You probably won’t benefit from this payment option if:
- You’re already getting help paying your drug costs.
- You have low, consistent, drug costs.
Review an example of how this payment option works if you have low, consistent monthly costs.
¿Qué más necesito saber?
If you get help from a Manufacturer’s Pharmaceutical Assistance Program paying for one of your drugs, but have other Medicare Part D drugs that are expensive, this payment option might be able to help you manage those costs.
¿Qué debería hacer después?
Contact your health or drug plan if you have specific questions about how the Medicare Prescription Payment Plan works or want more information.
Your answer:
This payment option probably won’t help you, but you might be eligible for other programs that can lower your costs.
The Medicare Prescription Payment Plan doesn’t lower your drug costs, it helps you manage your out-of-pocket Medicare Part D drug costs by spreading them across the calendar year (January – December). Based on your income, you may be eligible for programs that can lower your costs.
Your answer:
This payment option probably won’t help you.
The Medicare Prescription Payment Plan helps you manage your out-of-pocket Medicare Part D drug costs by spreading them across the calendar year (January – December). It doesn’t save you money or lower your drug costs. If your costs are already about the same each month, and you can afford those costs, this payment option probably won’t help you.
Review an example of how this payment option works if:
- You have low, consistent monthly costs.
- You have high drug costs early in the year.
¿Qué más necesito saber?
Your payments might change every month, so you might not know what your exact bill will be ahead of time. Future payments might increase when you fill a new prescription (or refill an existing prescription) because as new out-of-pocket costs get added to your monthly payment, there are fewer months left in the year to spread out your remaining payments.
There are specific situations, like an unexpected high drug cost early in the year (before September), where this payment option might be helpful. Review an example of how this payment option works if you have a sudden high cost.
¿Qué debería hacer después?
Contact your health or drug plan if you need more help deciding if this payment option is right for you.
Your answer:
This payment option probably won’t help you.
The Medicare Prescription Payment Plan helps you manage your out-of-pocket Medicare Part D drug costs by spreading them across the calendar year (January – December) but it doesn’t lower your drug costs.
Your payments might change every month, so you might not know what your exact bill will be ahead of time. Future payments might increase when you fill a new prescription (or refill an existing prescription) because as new out-of-pocket costs get added to your monthly payment, there are fewer months left in the year to spread out your remaining payments.
In a single calendar year (Jan – Dec), you’ll never pay more than:
- The total amount you would have paid out of pocket to the pharmacy if you weren’t using this payment option.
- The out-of-pocket maximum for prescription drugs that are covered by your plan ($2,000 in 2025).
¿Qué más necesito saber?
Depending on your situation, you may still find it helpful to spread out your payments across the calendar year (Jan – Dec) using this payment option if:
- You decide to participate in this payment option early in the year (before September), and most of your costs are earlier in the year. Review an example of how this payment option works if you have high drug costs early in the year .
- You have an unexpected high drug cost early in the year (before Sept). Review an example of how this payment option works if you have a sudden high cost.
¿Qué debería hacer después?
Contact your health or drug plan if you need more help deciding if this payment option is right for you.
Your answer:
Yes, this payment option is likely to help you.
You’ll find this payment option most helpful if:
- You decide to participate in this payment option early in the calendar year (like before September).
- Most of your costs are earlier in the year.
¿Qué más necesito saber?
Your payments might change every month, so you might not know what your exact bill will be ahead of time. Future payments might increase when you fill a new prescription (or refill an existing prescription) because as new out-of-pocket costs get added to your monthly payment, there are fewer months left in the year to spread out your remaining payments.
En un solo año calendario (enero – diciembre), nunca pagarás más de:
- The total amount you would have paid out of pocket to the pharmacy if you weren’t using this payment option.
- The out-of-pocket maximum for prescription drugs that are covered by your plan ($2,000 in 2025).
¿Qué debería hacer después?
Contact your health or drug plan if you need more help deciding if this payment option is right for you.
Your answer:
This payment option probably won’t help you.
The Medicare Prescription Payment Plan helps you manage your out-of-pocket Medicare Part D drug costs by spreading them across the calendar year (January – December), but it doesn’t lower your drug costs.
Your payments might change every month, so you might not know what your exact bill will be ahead of time. Future payments might increase when you fill a new prescription (or refill an existing prescription) because as new out-of-pocket costs get added to your monthly payment, there are fewer months left in the year to spread out your remaining payments.
En un solo año calendario (enero – diciembre), nunca pagarás más de:
- The total amount you would have paid out of pocket to the pharmacy if you weren’t using this payment option.
- The out-of-pocket maximum for prescription drugs that are covered by your plan ($2,000 in 2025).
¿Qué más necesito saber?
Depending on your situation, you might still find it helpful to spread out your payments across the calendar year (January – December) using this payment option if:
- You decide to participate in this payment option early in the year (before September), and most of your costs are earlier in the year. Review an example of how this payment option works if you have high drug costs early in the year.
- You have an unexpected high drug cost early in the year (before September). Review an example of how this payment option works if you have a sudden high cost.
¿Qué debería hacer después?
Contact your health or drug plan if you need more help deciding if this payment option is right for you.