Form CMS-10882 Likely to Benefit Notice

Consider Managing Your Monthly Drug Costs with the Medicare Prescription Payment Plan

You’re likely to benefit from participating in the Medicare Prescription Payment Plan because you have high drug costs.

What’s the Medicare Prescription Payment Plan?

The Medicare Prescription Payment Plan is a payment option that works with your current drug coverage to help you manage your out-of-pocket costs for drugs covered by your plan by spreading them across the calendar year (January–December). Anyone with a Medicare drug plan or Medicare health plan with drug coverage (like a Medicare Advantage Plan with drug coverage) can use this payment option. All plans offer this payment option, participation is voluntary, and there’s no cost to participate.

This payment option might help you manage your monthly expenses, but it doesn’t save you money or lower your drug costs. If you have low or stable drug costs, then this payment option might not be the best choice for you.

How will my costs work?

When you fill a prescription for a drug covered by Part D, you won’t pay your pharmacy (including mail order and specialty pharmacies). Instead, you’ll get a bill each month from your health or drug plan. Your monthly bill is based on what you would have paid for any prescriptions you get, plus your previous month’s balance, divided by the number of months left in the year.

Note: Your payments might change every month, so you might not know what your exact bill will be ahead of time. Future payments might increase when you fill a new prescription (or refill an existing prescription) because there are fewer months left in the year to spread out your remaining payments.

Who can help me decide if I should participate?

• Your health or drug plan: Visit your plan’s website or call your plan to get more information. If you need to pick up a prescription urgently, call your plan.

• Medicare: Visit Medicare.gov/prescription-payment-plan to learn more about this payment option and if it might be a good fit for you.

• State Health Insurance Assistance Program (SHIP): Visit shiphelp.org to get the phone number for your local SHIP and get free, personalized health insurance counseling.

Visit your health or drug plan’s website or call your plan for more information, or to start participating in this payment option.

Need this information in another format or language? To get this material in other formats like large print, braille, or another language, contact your Medicare drug plan at the phone number on your membership card. If you need help contacting your plan, call 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.

Form CMS-10882 OMB Approval No. 0938-1475 (Expires: 07/31/2025)