Starting in 2025, Medicare Advantage plan members with Part D coverage can choose to manage their Medicare Part D out-of-pocket drug costs with the Medicare Prescription Payment Plan (M3P). This option, introduced under the Inflation Reduction Act, enables members to spread prescription expenses across the calendar year, helping to ease high monthly drug costs.

How the M3P Plan Works

Under the M3P, members will continue paying monthly premiums but will be billed for their prescription drugs by their health plan, rather than paying directly at the pharmacy. This structured billing process aims to help members better manage their monthly cash flow, particularly for those with significant drug costs. Patients that have high drug costs earlier in the calendar year are most likely to benefit from participating.

Enrollment Process and Key Details

• Enrollment Options: Members can opt into M3P through an online portal, by phone, or by submitting a form by mail. Participation is voluntary, with no added fees or interest on unpaid balances, even if payments are late.
• Monthly Payment Calculation: Payments will vary each month based on recent prescriptions and the time left in the year to spread costs. As members continue filling prescriptions, monthly payments may increase.
• Eligibility Considerations: Members will receive an M3P enrollment form with annual enrollment materials.

Who May Not Benefit from M3P

The M3P may not be ideal for all beneficiaries, particularly those with:

• Low yearly prescription costs,
• Fixed monthly prescription expenses,
• Extra Help or other subsidies for Part D costs.

Additional Resources

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