For Members
For Providers
The Medicare Prescription Payment Plan (M3P) launching in 2025, is a significant step towards improving prescription drug affordability for Medicare beneficiaries. This program allows Medicare Part D members to spread their out-of-pocket Part D prescription drug costs throughout the plan year, alleviating the burden of high upfront payments at the pharmacy.
Reporting on behalf of Part D sponsors, including payments, collections, PDEs and other CMS data/reporting requirements.
Track member spending & balances with dedicated financial fields for simplified M3P cost management.
Streamline member elections with web, mobile, telephonic and mail options, plus informative program benefits.
Accept all major payment methods(credit/debit cards, ACH, checks) for easy transactions.
Alert pharmacies when enrollees can benefit from the program.
JUDI automatically updates the maximum monthly cap threshold for M3P compliance.
Reporting on behalf of Part D sponsors, including payments, collections, PDEs and other CMS data/reporting requirements.
Track member spending & balances with dedicated financial fields for simplified M3P cost management.
Streamline member elections with web, mobile, telephonic and mail options, plus informative program benefits.
Accept all major payment methods(credit/debit cards, ACH, checks) for easy transactions.
Alert pharmacies when enrollees can benefit from the program.
JUDI automatically updates the maximum monthly cap threshold for M3P compliance.
This provision applies to Part D sponsors, including stand-alone Medicare prescription drug plans (PDPs) and Medicare Advantage (MA) plans with prescription drug coverage (MA-PDs), as well as Employer Group Waiver Plans (EGWPs), cost plans, and demonstration plans. Not all Part D plans are required or eligible for the program, LI NET, PACE, and MMP are excluded from the M3P.
All covered Part D drugs are included in the program. Part D sponsors may not exclude any covered Part D drugs, and once a Medicare Part D enrollee has opted in, all their out-of-pocket Part D prescription drug costs will be billed monthly, as required, while they are in the program.
No, total out-of-pocket Medicare Part D drug costs will not change. Opting into the program will not affect how people with Medicare move through the Part D benefit or what counts toward their deductible or annual out-of-pocket cost threshold. The only difference is how and when payments are made (monthly payments to the plan instead of at the pharmacy).
Enrollees will be able to pay high cost-sharing amounts monthly instead of all at once at the pharmacy, improving affordability and access to drugs. This will help participants manage high-cost drugs by spreading out the costs over time.
Yes, Part D sponsors must provide ALL Part D enrollees with the option to opt into the M3P program, including those in the Extra Help program.
Beginning with plan year 2025, Part D enrollees may opt into the program before the start of a plan year or in any month during one.