July 29, 2024

Avisery Alert:

New Medicare Prescription Payment Plan Program to be Offered in 2025 


Background:

The Medicare Prescription Payment plan is a new and optional program that allows beneficiaries with higher Medicare Part D prescription drug costs to spread out their drug costs throughout the calendar year. Beneficiaries who enroll in the program will make capped monthly payments to their plan instead of paying their entire co-insurance or co-payment amount at the pharmacy. It is important to note that this new program does not lower or help pay a beneficiary’s drug co-pay or coinsurance amounts, but instead allows beneficiaries to manage high out-of-pocket drugs costs by making monthly payments to their plan instead of paying it all at once at the pharmacy.


Beneficiaries who choose to participate will not have to pay any interest fees on their payments. All Medicare Part D pans, including stand-alone Part D plans that cover only drugs and Medicare Advantage plans that offer drug coverage, will be required to offer the program. 


It is also important to note that beginning in 2025, the new Medicare Part D annual maximum out-of-pocket limit for all beneficiaries will be $2,000 This means that once a beneficiary incurs $2,000 in out-of-pocket costs for covered drugs, they will pay nothing for the remainder of the calendar year. The new limit is the result of a different provision of the Inflation Reduction Act. 


The Centers for Medicare and Medicaid Services (CMS) have released program guidance and a timeline that can be found here: https://www.cms.gov/inflation-reduction-act-and-medicare/part-d-improvements/medicare-prescription-payment-plan.


Avisery Q&A Resource Document about the Medicare Prescription Payment Plan:

Avisery has created a Q&A resource document that addresses key questions about the Medicare Prescription Payment Plan. Click the link below to access the document:

Medicare Prescription Payment Plan Resource Sheet - AgeOptions


As always, feel free to reach out to Avisery with any questions at avisery@ageoptions.org.

Visit the Avisery Website
AgeOptions Logo
Facebook  Twitter  Instagram