What is the Medicare Prescription Payment Plan?

The Medicare Prescription Payment Plan is a payment option that can help you manage your prescription drug expenses throughout the year. It allows you to spread your out-of-pocket costs for drugs covered under Medicare Part D across monthly payments instead of paying the full amount at the pharmacy. 

How does the Medicare Prescription Payment Plan program work?

As a Jefferson Health Plans Medicare Advantage member with Part D prescription drug coverage, you can choose to participate in the Medicare Prescription Payment Plan. Participation is voluntary, and there is no cost to join.

If you participate:

• You will continue to pay your Jefferson Health Plans premium, if you have one.
• When you fill a prescription covered by Medicare Part D, you generally will not pay the pharmacy for your out-of-pocket cost at the time you pick up your prescription.
  • This includes participating retail, mail-order, and specialty pharmacies.
• Instead, Jefferson Health Plans will send you a monthly bill for the amount you owe under the Medicare Prescription Payment Plan.
• You are still responsible for your prescription drug costs. The program simply allows you to spread those costs over monthly payments.

This payment option does not lower your prescription drug costs or save you money.

• It may make your costs easier to manage by spreading what you owe over the remaining months of the calendar year.

Important:

• The later in the calendar year you enroll, the fewer months you will have to spread out your prescription drug costs. This may result in higher monthly payments.
• If you would like to know how much a prescription may cost before you fill it, call Member Relations or ask your pharmacist.

What Happens Next Year? 

Are you staying with the same health plan?

• If you are already participating in the Medicare Prescription Payment Plan and remain enrolled in the same Jefferson Health Plans Medicare Advantage plan, your participation will automatically continue into the next plan year.
• You will receive information after the Annual Enrollment Period explaining the automatic renewal.

Changing to a different Medicare Advantage plan?

• If you change health plans effective January 1, 2027, your current Medicare Prescription Payment Plan participation will end.
• You will need to enroll again through your new plan if you would like to continue using this payment option.