UPMC For Life: Medicare Prescription Payment Plan

There’s been much discussion lately about the new Medicare Prescription Payment Plan (M3P), which will begin Jan. 1, 2025. To help keep you informed and able to answer client questions, UPMC wanted to send some information regarding this new program.

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What is the Medicare Prescription Payment Plan?

The Medicare Prescription Payment Plan is a new payment option in the prescription drug law. It works with a member’s current drug coverage to help them manage their out-of-pocket Medicare Part D drug costs by spreading them across the calendar year (Jan.-Dec.). 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. All plans offer this payment option, and participation is voluntary.  There’s no cost to participate in the Medicare Prescription Payment Plan.

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How does it work?

If a Medicare member signs up for this payment option and fill a prescription for a drug covered by Part D, they won’t pay the pharmacy (including mail order and specialty pharmacies). Instead, they will get a monthly bill from their health or drug plan.

Even though Medicare members won’t pay for their drugs at the pharmacy, they are still responsible for the costs. This payment option helps manage monthly expenses, but it does not save money or lower drug costs.

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Who should sign up?

Members are most likely to benefit from participating in the Medicare Prescription Payment Plan if they have high drug costs earlier in the calendar year. Starting earlier in the year (like before September) gives members more months to spread out their drug costs.

To find out more about M3P and who may benefit from it, check out these resources:

• UPMC for Life M3P flier
• UPMC for Life Medicare Prescription Payment Plan webpage
• What's the Medicare Prescription Payment Plan – helps determine if M3P would be a good option

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