Medicare Prescription Payment Plan

The Medicare Prescription Payment Plan is a new payment option to help plan
participants manage out-of-pocket drug costs, starting in 2025. This new
payment option works with your current drug coverage, and it can help manage
drug costs by spreading them across monthly payments that vary throughout the year (January–December). This payment option might help you manage your expenses, but it doesn’t save you money or lower your drug costs.

Extra Help from Medicare and help from your SPAP and ADAP, for those who
qualify, is more advantageous than participation in the Medicare Prescription
Payment Plan. All members are eligible to participate in this payment option,
regardless of income level, and all Medicare drug plans and Medicare health
plans with drug coverage must offer this payment option.

In November, Optum Rx, the prescription drug plan administrator for the
Health Options Program, sent more information to members who are likely to benefit from this payment plan.

If you have questions or need help completing the enrollment form, contact Optum Rx at 1-844-368-8729, 5:00 a.m. – 10:00 p.m. CT, 7 days a week. TTY users can call 711.

If you are enrolled in a Medicare Advantage plan, contact the plan for additional information.

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

Important Documents and Information

Likely to Benefit Letter from OptumRx

Medicare Prescription Payment Plan Enrollment Form

Medicare Prescription Payment Plan Fact Sheet

Last Modified: November 22, 2024