Medicare Prescription Payment Plan

When you fill a prescription for a drug covered by Part D, you won’t pay your pharmacy. Instead, you’ll get a bill each month from your Medicare health or drug plan.

As you purchase new prescriptions throughout the year, your monthly payments will adjust accordingly. This means you might not know what your exact bill will be ahead of time, and your payments can change from month to month. Still, by spreading payments throughout the year the Prescription Payment Plan can help make out-of-pocket expenses more predictable and easier to track.

Anyone with a Medicare drug plan or a Medicare health plan with drug coverage can sign up during the Annual Enrollment Period after you plan enrollment is confirmed, or any time during the plan year.

You’re most likely to benefit from the Medicare Prescription Payment Plan if you have high drug costs earlier in the calendar year.

Visit Medicare.gov⁠ and answer a few questions to find out if you're likely to benefit from this payment option.

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.

Although you can start participating in this payment option at any time in the year, starting earlier in the year gives you more months to spread out your drug costs.

You take several high-cost drugs that have a total out-of-pocket cost of $600 each month. In January 2027, you join the Medicare Prescription Payment Plan through your Medicare drug plan or Medicare health plan with drug coverage.

We calculate your first month’s bill in the Medicare Prescription Payment Plan differently than your bill for the rest of the months in the year:

Even though your payment varies each month, by the end of the year, you’ll never pay more than:

• The total amount you would have paid out-of-pocket.
• The total annual out-of-pocket maximum ($2,400 in 2027).

Remember, this is just your monthly payment for your out-of-pocket drug costs. You still need to pay your health or drug plan’s premium (if you have one) each month.

If you’re concerned about paying $600 each month from January to April, this payment option will help you manage your costs. If you prefer to pay $600 each month for 4 months and then pay $0 for the rest of the year, this payment option might not be right for you. Contact your health or drug plan for personalized help.

You take several drugs that have a total out-of-pocket cost of $80 each month. In January 2027, you join the Medicare Prescription Payment Plan through your Medicare drug plan or Medicare health plan with drug coverage.

We calculate your first month’s bill in the Medicare Prescription Payment Plan differently than your bill for the rest of the months in the year:

Even though your payment varies each month, by the end of the year, you’ll never pay more than:

• The total amount you would have paid out-of-pocket.
• The total annual out-of-pocket maximum ($2,400 in 2027).

Remember, this is just your monthly payment for your out-of-pocket drug costs. You still need to pay your health or drug plan’s premium (if you have one) each month.

You pay $4 every month in out-of-pocket costs for a prescription you use regularly. In April 2026, you need a new one-time prescription that costs $613, so your total out-of-pocket costs in April are $617. That same month, before you fill your prescriptions, you decide to participate in the Medicare Prescription Payment Plan through your Medicare drug plan or Medicare health plan with drug coverage.

We calculate your first month’s bill in the Medicare Prescription Payment Plan differently than your bill for the rest of the months in the year:

Your payments will vary throughout the year. That’s because you’re adding drug costs during the year, but you have fewer months left in the year to spread your payments across.

By the end of the year, you’ll never pay more than:

• The total amount you would have paid out-of-pocket.
• The total annual out-of-pocket maximum ($2,400 in 2027).

Remember, this is just your monthly payment for your out-of-pocket drug costs. You still need to pay your health or drug plan’s premium (if you have one) each month.

If you’re concerned about paying $617 in April, this payment option will help you spread your costs across monthly payments that vary throughout the year. If you’re concerned about higher payments later in the year, this payment option might not be right for you. Contact your health or drug plan for personalized help.

Once you're enrolled, when you pick up a covered prescription, your Medicare plan will automatically let the pharmacy know that you’re participating in this payment option. Even though you won’t pay for your drugs at the pharmacy, you’re still responsible for the out-of-pocket costs. If you want to know what your drug will cost before you take it home, call customer service at the number on the back of your member ID card or ask the pharmacist.

Each month, your plan will send you a bill with the amount you owe for your prescriptions, along with information on how to make a payment. Your plan premium, if there is one, will be billed and paid separately.

You can leave the Medicare Prescription Payment Plan at any time by contacting your health or drug plan. If you leave your current plan or switch to a new plan, your participation in the Medicare Prescription Payment Plan will end, and you'll be asked to pay your remaining balance. However, you can re-enroll in the Medicare Prescription Payment Plan under your new coverage. In this case, you will receive bills from both plans until your account is paid in full.

Members can submit a complaint or grievance to Medicare. Visit the Prescription drug coverage determinations, appeals, and grievances page to get help with appeals and grievances for your Medicare drug coverage.