If you have high prescription drug costs,
a new program under Medicare Part D may benefit you.
Here's what you need to know.
Each year, Medicare limits the amount
you pay out of pocket for covered part D prescription drugs.
Medicare will review and update this amount each year.
If you take high cost part D drugs,
you might reach the spending cap early in the year.
That's where the Medicare prescription payment plan might benefit you.
If you sign up for the program, you will be able to spread
your out-of-pocket costs across the remainder of the calendar year.
Signing up for the program means you won't pay
for your prescription drugs at the pharmacy or when they're shipped.
Instead, your plan will send you a bill each month separate from your plan.
Premium bill.
Your monthly bill
is based on the part D prescription drugs filled that month,
plus your previous month's
balance divided by the number of months left in the plan year.
This amount may change monthly.
Participation is optional and there are no fees to sign up.
Keep in mind this payment option might help you manage your expenses,
but it won't save you money or lower your drug costs.
And it's not a good choice for everyone.
If you're likely to reach Medicare's out-of-pocket
spending cap early in the year and you enroll in the payment plan early
before you fill many prescriptions, it might benefit you.
It made sense for John.
John takes a high cost prescription drug for his chronic heart condition.
If he begins filling his prescription in January,
he'll reach the annual out-of-pocket limit in April.
Meaning John
won't pay anything for his covered drugs for the remainder of the year.
But if John signs up for the payment plan in January,
he will be able to spread his part D drug costs over the year.
This payment plan
might not be a good choice for you if you're out of pocket.
Prescription costs are lower than the annual spending cap.
Your drug costs are similar each month.
You sign up later in the plan year.
You get extra help from Medicare,
your enrolled in a dual eligible special needs plan
or other program like Medicaid that assists with your drug costs
or you don't want to change how you pay for your prescriptions.
Laura
decided the program didn't make sense for her.
She mostly takes lower cost generic drugs, and her monthly
prescription costs ranged from $100 to $160.
Even with a few unplanned prescriptions, Laura won't reach
the annual out-of-pocket limit, so this program won't benefit her.
In fact, her monthly payments would increase
as she continues to pick up prescriptions with fewer months left in the year.
Remember, this payment option
might not be the best choice for you, depending on your part D drug costs.
To learn more about the Medicare prescription
payment plan and determine if it makes sense for your situation,
call the number on the back of your member ID card or visit your plan’s website.