Mr. Hildalgo complains to you that because he takes multiple expensive drugs, he has trouble paying his cost sharing for his prescription drugs, particularly at the beginning of the year during the deductible phase. He is happy with his plan and does not want to change. However, he said he had heard about a new program called the Medicare Prescription Payment Plan and asked whether it might help. What do you tell him?



Answer :

You're correct that there is a new program called the Medicare Prescription Payment Plan that was launched in 2024 to help Medicare beneficiaries with their out-of-pocket prescription drug costs. This voluntary program allows enrollees to pay a fixed monthly amount for their prescription drugs rather than paying full cost-sharing amounts at the pharmacy counter.

Here are the key points about the program that are relevant to your situation:

- The plan evens out prescription costs over the course of the year, so you don't face high out-of-pocket costs all at once during the deductible phase. Instead, you pay a consistent monthly amount.

- You can still keep your current Medicare drug plan that you are happy with. The Payment Plan works with your existing coverage.

- Enrolling in the Payment Plan does not change the total amount you pay for your prescriptions over the course of the year, but it can help make your monthly costs more predictable and manageable.

- There are no additional premiums to participate. You just pay the monthly amount calculated based on your expected annual prescription costs.

Given the trouble you've had paying your drug costs, particularly during the deductible phase, the Medicare Prescription Payment Plan sounds like it could be a good fit for you. I'd recommend looking into it further, understanding how your monthly payment amount would be determined, and considering enrolling during the next enrollment window if you feel it would help you better afford your medications.

Let me know if you have any other questions! I'm happy to discuss the program with you in more detail.

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