What is the Medicare Prescription Payment Plan?

• This is a voluntary payment option available with any Medicare Part D or Medicare Advantage plan that includes drug coverage.

• Instead of paying at the pharmacy every time you fill a prescription, you opt into the plan and your drug plan bills you monthly for your prescription costs. 

• You still pay the same total amount you would owe overall — this plan simply spreads the cost out over the year. 

➡️ Key point: This doesn’t save money or lower total drug costs — it just changes how you pay. 

How the monthly bill works

• You continue paying your plan premium as usual (if your plan has one). 

• Instead of paying at the pharmacy, your plan pays the pharmacy and then bills you monthly. 

• The bill is calculated based on:

  • What you would have paid at the pharmacy,

  • Your prior month’s balance, and

  • How many months are left in the year to spread the remaining cost. 

You might see your monthly payment change if you fill more prescriptions later in the year because there are fewer months left to spread the cost.

What this means for your out-of-pocket costs

• Starting with the 2024 benefit changes and continuing into 2026, Medicare Part D has a hard annual out-of-pocket cap on your covered drug costs (deductible + copays/coinsurance), currently set around $2,100 for 2026. 

• That means even if you spread costs monthly, you will never pay more than the annual out-of-pocket maximum for covered drugs. 

• The payment plan doesn’t reduce total costs, but it can help you budget by avoiding large lump-sum payments at the pharmacy.

Is this good for you?

The Medicare Prescription Payment Plan can be helpful if:

• You take high-cost medications, especially early in the year. 

• You prefer a predictable monthly cost rather than fluctuating pharmacy bills. 

• You want to avoid paying a large deductible or coinsurance payment all at once. 

But it doesn’t reduce what you pay overall — the total amount due won’t be less than if you had paid at the pharmacy each time.

📍 Important things to know

• You must opt in — you are not automatically enrolled. 

• You still owe your plan premiums in addition to your drug cost bill. 

• This doesn’t change which drugs are covered — it only changes how you pay for them

Contact Customer Service using the number on the back of your plan card and ask about enrolling in the Prescription Payment Plan. They can walk you through the setup.