Open enrollment ends tomorrow on Saturday, December 7.

Our 2025 Medicare Part D Communication Series will continue into the new year, as needed.

You can access our array of tools and resources by visiting the Member Portal and select Medicare Part D from the main menu.

We want your feedback on our 2025 Medicare Part D Resources!

We invite you to share your experience using the Medicare Part D resources we provided to you this year. We greatly value your input, as this will help us to plan for next year. Please note that all responses are confidential.

The 2025 Medicare Part D Search Tool on the Member Portal includes a list of contracted plans. Learn how to export and filter the vast amount of data so you can identify and compare plans for your patients.

Click below to view our webinar or how-to video on this topic. You can also find these resources on the Member Portal. Select Medicare Part D from the main menu and navigate to the References & Links tab.

KEY POINTS—The Inflation Reduction Act (IRA): Medicare Prescription Payment Plan

• The Medicare Prescription Payment Plan is not for everyone.
• If the beneficiary’s plan believes they are “Likely to Benefit” from opting into the Payment Plan, the pharmacy will receive a message in the paid claim response after billing their Part D plan. Pharmacies are required to provide a Medicare beneficiary with a Likely to Benefit notice.
• If a beneficiary has opted into the Payment Plan, the pharmacy will receive additional processing information in the paid claim response, directing them how to bill for the remaining copayment.
• Each Part D sponsor will utilize unique processing information. The pharmacy will bill any remaining out-of-pocket cost via a Coordination of Benefits (COB) as a secondary (or tertiary) transaction.
• A beneficiary enrolled in the Payment Plan will not pay a copayment at the pharmacy.

Click here for an overview of important changes for Medicare in 2025, including an implementation timeline of the IRA and frequently asked questions. AlignRx will continue to provide information as it becomes available.

The AlignRx 2025 Annual Medicare Part D Guide includes:

• High-level plan information organized by PBM
• How to report fraud, waste, and abuse 
• Links to useful websites
• List of acronyms and definitions 

For 2025 Medicare Part D, AlignRx is not contracted with:

• Caremark
• Express Scripts (includes Prime Therapeutics)

To ensure you have the most updated version, please visit the Member Portal and select Medicare Part D from the main menu.

AlignRx's searchable reporting tool identifies patients whose plans will not be under contract with AlignRx in 2025. You can use this tool to determine which patients may need to be notified of plan changes. The tool includes: Patient Information; Payor; Plan; BIN/PCN/Group; Rx Count; and Gross Profit Estimate. Please visit the Member Portal and select Medicare Part D from the main menu. Then navigate to the Patient Data tab.

Get marketing resources to inform your patients about Medicare Part D plans your pharmacy will/will not be accepting in 2025. Choose from a variety of materials (such as a poster, flyer, postcard, and bag insert) that you can print in-house or send to a local printer. Please visit the Member Portal and select Medicare Part D from the main menu. Then navigate to the Marketing Resources tab.

REMINDER: Your pharmacy can partner with Rx Insurance Group to provide Medicare plan guidance to your patients. Rx Insurance Group offers solutions to help guide patients in selecting a Medicare Advantage Plan, Medicare Prescription Drug Plan (PDP), or Medicare Supplement Insurance Policy (Medigap) that best meets their needs. Learn more by clicking the "Medicare: Help Guide Your Patients" button on the Member Portal. Questions? Contact Matt Coakley: Matt@waypointus.com or 843-873-4420, x9

QUESTIONS? AlignRx Pharmacy Services: 844-ALIGNRX (844-254-4679), option 1