New for 2025
The Medicare Prescription Payment Plan
What is the Medicare Prescription Payment Plan?
High prescription costs shouldn’t prevent beneficiaries from getting the care they need. The Medicare Prescription Payment Plan gives anyone with a Medicare drug plan or Medicare Advantage plan with drug coverage the option to pay out-of-pocket prescription costs over time.
Here’s how it works if a beneficiary opts in: The Medicare plan pays the pharmacy directly for beneficiary's medications. The beneficiary repays their plan in monthly installments with no interest or fees. Beneficiaries get certainty of affordability for their prescriptions throughout the year. This means if they opt in, they'll pay $0 when they get their medications. Instead, their out-of-pocket prescription costs will be billed to them in monthly installments from their plan.
You can opt in for 2025 at any time and opt in early for 2026 beginning on October 15th, 2025. Sign up today by clicking “Opt In Now” and filling out the form or calling your plan.
How It Works
Why opt-in ?
Benefits of the Medicare Prescription Payment Plan
Lower Monthly Prescription Drug Costs
Spread out costs over time and avoid large bills at the pharmacy counter.
Help with Prescription Costs
Designed to enable prescription assistance for someone with Medicare, this program provides financial relief for those struggling to manage high prescription expenses.
Affordable Prescriptions for Seniors
With this program, essential medications are more accessible for seniors, making it easier and less stressful to stay healthy.
Calculate Potential Monthly Rx Costs
Use this simple calculator to see how the new Medicare Prescription Payment Plan impacts your prescription payments over time.
To use it, you’ll need to know what your monthly prescription costs were each month in the last year. If you're not sure what your costs were or will be, you can estimate some costs to see how the program works. No personal information will be collected, saved, or shared.
While this calculator is not associated with the Centers for Medicare & Medicaid Services, it is made using the calculations set forth publicly for the Medicare Prescription Payment Plan program which can be viewed online here.
How It Works
If beneficiaries need help paying for prescription medications, they can watch this short video to learn more about how the Medicare Prescription Payment Plan can benefit them.
FAQs
Commonly Asked Questions
Who is eligible for Medicare’s Prescription Payment Plan?
All Medicare Part D beneficiaries are eligible! Anyone with a Medicare drug plan or Medicare health plan with drug coverage, such as a Medicare Advantage Plan with drug coverage, can take part in this program.
What is the annual limit for out-of-pocket costs for the Medicare Prescription Payment Plan?
For 2025, the annual limit for out-of-pocket costs for Medicare Part D beneficiaries is $2,000, and in 2026, the annual OOP limit is $2100. The Medicare “donut hole” went away in 2025, so the most you can spend out-of-pocket on covered Part D, or outpatient, prescription drugs is the out of pocket maximum amounts listed above.
Is there a cost to enroll in the Medicare Prescription Payment Plan?
No, there’s no cost to enroll, and the payment plan is completely interest-free.
How do I opt in to the Medicare Prescription Payment Plan?
To opt in quickly and securely, complete your opt in form using our opt in tool, located here.
Is there a limit to the number of prescriptions covered under the Medicare Prescription Payment Plan?
No, if you opt in, the program will automatically spread the cost of all covered Part D drugs that you fill at the pharmacy.
Can I use the Program for all prescriptions?
Yes, the Medicare Prescription Payment Plan covers all eligible prescriptions under your Medicare plan.
Who Built this Educational Site?
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