New Medicare Program Makes Prescription Costs Easier to Handle

October 10, 2024 at 17:06 PM EDT

(BPT) - This year's Medicare Annual Enrollment brings a major change for prescription drug users: a new payment program for older adults and those with disabilities to spread out their costs over time, making it easier to manage out-of-pocket expenses.

With 90% of Americans over 65 taking at least one prescription, and one in five skipping doses due to costs (Source: KFF), this plan could make a meaningful difference for millions, helping them afford the medications they need to stay healthy. Starting in 2025, Medicare drug plan members can spread out their prescription costs over time, avoiding the need to pay in full each time they fill a prescription.

'The Medicare Prescription Payment Plan is an important new option that can help Medicare beneficiaries manage their prescription drug costs and access the medications they need,' said Patrick Wildman, Senior Vice President of Advocacy at the Lupus Foundation of America. 'The option to spread out prescription costs over the course of the year is critical - especially for those living with chronic and serious conditions like lupus who can have high drug costs and who rely on multiple medications to manage their disease.'

What Does This Mean for You?

Eligible beneficiaries can enroll in the Medicare Prescription Payment Plan during annual enrollment starting Oct. 15, 2024 and throughout the plan year. This benefit, along with a newly instituted $2,000 out-of-pocket maximum for Medicare Part D members, represents the biggest change to Medicare since the introduction of Part D in 2006. The 'donut hole' will disappear in 2025, so no one will have to pay more than $2,000 per year for their covered prescriptions.

This change means you can worry less about managing large bills at the pharmacy, and instead spread those costs out over manageable monthly payments, giving you more control over your finances.

Who Benefits the Most?

While all eligible beneficiaries can use the new program to better plan and manage prescription costs, the Centers for Medicare and Medicaid Services (CMS) has previously stated that those most likely to benefit include anyone who spent more than $2,000 on out-of-pocket prescription costs in the past year and anyone struggling to pay out-of-pocket costs upfront at the pharmacy.

Pharmacists Are Ready to Help

Pharmacists nationwide are prepared to answer customer questions about the program. However, beneficiaries will need to enroll via their Part D plan sponsor before they can receive their medications for $0 upfront at the pharmacy.

'Taking your medications as prescribed is one of the most impactful things you can do for your overall health and well-being,' said Summer Kerley, Vice President of Health Plan Solutions for Rite Aid Corporation. 'By spreading out your payments, this program makes it easier to stay on track with medications, which means better disease management and better quality of life.'

The Future of Cost Smoothing in Healthcare

This shift in spreading healthcare costs over time is becoming a standard approach across the industry, with commercial insurers, employer plans, and Medicare embracing cost smoothing programs. The solutions provide certainty of affordability, allowing more patients to access the care they need without the stress of large, unexpected bills.

Don't Miss Out - Explore Your Options

With the Annual Enrollment period opening Oct. 15, 2024, now is the time to explore your options. Visit Medicare.gov, Paytient.com/MPPP, or call your Medicare plan provider to see if you qualify and learn how to enroll. Don't wait - taking control of your healthcare costs today could mean better health and financial stability in 2025 and beyond.

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New Medicare Program Makes Prescription Costs Easier to Handle

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