Your guide to the Medicare Prescription Payment Plan

The Medicare Prescription Payment Plan is a program required under the Inflation Reduction Act. Eligible Part D enrollees can opt to manage their out-of-pocket prescription drug costs with monthly payments instead of all at once. Please note, this program does not save you money or lower your drug costs—it’s a monthly installment payment plan. 

 

Here’s a deeper look into the Medicare Prescription Payment Plan.

The Medicare Prescription Payment Plan (MPPP) is an optional program that can help you manage your prescription payments. With this program:

  • Costs for your covered Part D prescriptions are spread out over the plan year.
  • You pay $0 at the pharmacy when you fill new or existing covered Part D prescriptions.
  • You’ll receive a monthly bill from CarePlus with the amount you owe, your due date and instructions on how to make a payment.

Note: This program can only help you manage your expenses—it can’t save you money or lower your drug costs.

The Medicare Prescription Payment Plan may help you manage your Part D prescription drug costs. Here are some tips to help you decide if this payment option might be helpful to you:

  • If during the prior plan year, you filled a single prescription costing more than $600.
  • If you have spent more than $2,000 on your covered Part D prescriptions. Effective Oct. 1, 2025, this limit will increase to $2,100 for 2026.
  • If you sign up early in the new plan year (the more months you have in the program, the more your payments will be spread out).

This payment option might not be helpful if you:

For more information visit Medicare.gov's Prescription Payment Plan page or contact your local Social Security office. You can find your local Social Security office at https://www.ssa.gov/locator or by calling 800-772-1213, Monday – Friday, 8 a.m. – 7 p.m. local time. TTY users can call 800-325-0778.

To learn if you may be eligible for state and federal benefits, and for help applying, call the CarePlus Social Services team at 855-392-3900 (TTY: 711), Monday – Friday, 8 a.m. – 5 p.m.

Once you have enrolled in a Medicare Advantage Plan or Prescription Drug Plan , you can opt in to the Medicare Prescription Payment Program at CarePlusHealthPlans.com/MPPP MyCarePlus.

Here you’ll find:

  • Program information
  • Frequently asked questions
  • Balance and transaction history
  • and more!

To opt-in offline, you can print, fill out and mail a Medicare Prescription Payment Plan Participation Request Form to the address on the form:

If you would like to opt-in by phone or have any questions about the Medicare Prescription Payment Plan, please call Member Services.

Voluntary opt out of the Medicare Prescription Payment Plan

When you opt out of The Medicare Prescription Payment Plan, here’s what happens: 

  • Going forward, you’ll pay your pharmacy directly for all your covered Part D drug costs. (This also applies to mail-order and specialty pharmacies).
  • You will stop purchases from being added to your balance. 
  • You will continue to receive monthly bills for the amount incurred while in the program until your balance is paid.
  • You also have the option to pay the balance in full at any time.

If you choose to participate in the program in the future, you simply opt in as you did before.

Do I need to opt in every year?

If you continue with your current CarePlus MAPD plan, your participation in the Medicare Prescription Payment Plan (MPPP) with your current CarePlus MAPD plan will extend into the next plan year unless you opt out of the program. If you change to another CarePlus MAPD plan, you will need to enroll again.

In the Medicare Prescription Payment Plan (MPPP), you will get a monthly bill from CarePlus instead of paying for your covered Part D prescriptions at the pharmacy. For your first month, based on your start date in the program, your monthly payment could be as high as your total covered Part D drug costs for that month.

Your monthly bill is based on what you owe for any prescriptions you get plus any balance from the previous month, divided by the number of months left in the year. Your payment can change every month as you fill new prescriptions or refill existing ones. These will be added to your balance which may change from month to month.

In 2025, you won’t pay more than $2,000 for out-of-pocket costs for covered Part D drugs. This is true for everyone with Medicare drug coverage, even if you don’t opt into the program. Starting in 2026, this amount will increase to $2,100 for out-of-pocket costs for covered Part D drugs.

It doesn’t cost anything to participate in the program and you won’t pay any interest or fees on the amount you owe.

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Estimate your monthly payment with this calculator by entering your estimated Part D prescription costs.

Note: Your monthly payment calculation is done every month to capture both your balance, and the remaining months left in the year.

If you don’t pay your monthly bill

If you don’t pay your past-due balance, here’s what you can expect: 

  • You will continue to receive bills until your past-due balance is paid. 
  • There is a 60-day grace period from your payment due date to your termination from the program.
  • You will be ineligible to re-join the program until your past-due balance is paid.
  • Once your past-due balance is paid, you can rejoin the program anytime.

Note: This only applies to your participation in the Medicare Prescription Payment Plan. Your Medicare drug coverage and other Medicare benefits won’t be affected, and you’ll continue to be enrolled in your plan for your drug coverage.

Here are some contacts that could help you decide if the program is right for you:

  • Medicare— Visit Medicare.gov, or call 1-800-MEDICARE (1-800-633-4227), 24 hours a day, 7 days a week. TTY users can call 877-486-2048.
  • State Health Insurance Program (SHIP)— Visit shiphelp.org to get the phone number for your local SHIP and to get free, personalized health insurance counseling.
  • CarePlus— If you have questions about the Medicare Prescription Payment Plan, please call Member Services

If you are dissatisfied with any aspect of the Medicare Prescription Payment Plan, you have the right to ask CarePlus to reconsider our decisions through the grievance process.  You must submit your dispute within 60 calendar days after the incident or event initiating the grievance. 

You may file an oral grievance by calling Member Services

You may fax or mail your grievance request to: 

CarePlus Health Plans, Inc.
Attn: Grievance & Appeals department
P.O. Box 277810
Miramar, FL 33027
Fax number: 1-800-956-4288