Florida Blue Medicare Spotlight: 2025 Part D Changes and M3P Program

The Inflation Reduction Act (IRA) Brings Sweeping Changes for Florida Blue Customers in 2025.

Help your customers understand the changes for the coming year to best manage prescription costs.

Florida Blue Medicare Brokers should have all of the tools to help customers understand the benefits available to them for 2025. Below is a summary of changes as part of the Inflation Reduction Act, bringing flexible options to customers to manage their prescription costs.

Out-of-pocket Expenses Capped at $2,000: Customers no longer experience a coverage gap between initial coverage and catastrophic coverage, with total OOP expenses limited to $2,000 for all beneficiaries starting in 2025.

Extra Help: Florida Blue offers Extra Help, a program that provides additional financial assistance to beneficiaries who qualify.

Availability of the Medicare Prescription Payment Plan (M3P): Separate from Extra Help, beneficiaries can enroll in the new Medicare Prescription Payment Plan (M3P) to help manage annual prescription drug costs. This is not a cost saving program, but rather a payment plan option for qualified beneficiaries to manage their costs annually.

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What is the Medicare Prescription Payment Plan (M3P)?

Help members manage and pay prescription costs throughout the year

• The Medicare Prescription Payment Plan is a new payment option to help manage out-of-pocket Medicare Part D drug costs.
• The M3P program spreads drug costs across the calendar year (January-December).
• This payment option may help the member manage monthly expenses, but it doesn't save them money or lower drug costs.
• Starting in 2025, anyone with a Medicare drug plan or Medicare health plan with drug coverage (like a Medicare Advantage Plan with drug coverage) can use this payment option.
• Participation is voluntary.
• Members who opt-in would continue to pay plan premiums, if applicable.
• Instead of paying the pharmacy, opted-in members will get a bill from the health or drug plan to pay for their prescription drugs.
• Members are still responsible for their drug costs even though the member won't pay for drugs at the pharmacy
• There's no cost to participate in the Medicare Prescription Payment Plan.

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