The Centers for Medicare & Medicaid Services (CMS) have released their final guidance on the Medicare Prescription Payment Plan, which will start next year. This plan will offer individuals with Medicare Part D coverage the choice to pay their out-of-pocket prescription drug costs in monthly installments instead of paying the full amount at the pharmacy counter. The final guidance complements CMS’ upcoming national education and program implementation efforts, which will be coordinated with Part D plans, pharmacies, providers, drug manufacturers, and beneficiary advocates. CMS has also released a fact sheet providing an overview of the final guidance.
Starting in 2025, all Medicare prescription drug plans (Medicare Part D plans), including standalone Medicare prescription drug plans and Medicare Advantage plans with prescription drug coverage, will be required by the prescription drug law to offer Part D enrollees the option to pay out-of-pocket prescription drug costs in monthly payments instead of all at once. This program, known as the Medicare Prescription Payment Plan, will be beneficial for individuals with high cost sharing earlier in the plan year, as it will spread out those expenses over the course of the plan year. Although this program is available to all Part D enrollees, CMS is developing tools to help Part D enrollees and their caregivers determine whether the program is suitable for them, as not all enrollees may benefit from it.
