Providers

Medicare Prescription Payment Program

A New Program That Makes Rx Drugs More Affordable by Allowing Medicare Members to Spread Their Prescription Costs Over Time

Passed into law August 2022 by President Biden, H.R. 5376 — Inflation Reduction Act (IRA) includes policies on Medicare drug pricing. The IRA significantly reforms the Medicare Part D benefit design, including a new program, Medicare Prescription Payment Plan (M3P), which will be available to all eligible Medicare members¹, beginning Jan. 1, 2025.

Program Overview for Eligible Participating Medicare Members¹

• Financial benefits to all Medicare members¹ in 2025 include an elimination of the coverage gap and capping the maximum out-of-pocket (OOP) prescription costs at $2,000 annually — which beneficiaries can spread across the plan year.
  
  
• M3P participants will pay $0 at the pharmacy for covered Part D drugs and be billed monthly for any cost-sharing they incur while in the program. Importantly, this will help them manage prescription costs by enabling them to spread their monthly payments over time.
  
  
• Payment might change every month as additional prescriptions are filled.
  
  
• The program is voluntary, and eligible members can choose to opt-in to the program during the annual enrollment period and throughout the plan year. Members can conveniently opt-in via online, by phone, or mail.
  • Online: express-scripts.com/mppp
  • Phone: 1-833-750-9969
  • Mail: Mail Express Scripts Medicare
    Prescription Payment Plan
    P.O. Box 2
    St. Louis, MO 63166 

• Existing members will receive additional information in their Annual Notice of Change.
  
  
• New members will receive additional information within 10 days of confirmed enrollment.

¹Excludes plans that solely charge $0 cost sharing for Part D covered drugs. See your plan’s Evidence of Coverage for more details.

Questions or Concerns?

As always, we encourage you to use the resources on Medicare.gov/prescription-payment-plan or to contact your Provider Services team.