Medicare AdvantageAdministrativeMedium impact
CMS implements prescription payment plan
UPMC Health Plan·Reimbursement
Effective date
Jan 1, 2025
We identified it
Jun 20, 2026
Summary
Starting January 1, 2025, all Medicare drug plans must offer a new Medicare Prescription Payment Plan that allows patients to pay $0 at the pharmacy and make monthly payments for prescription drug costs instead of paying all at once. Pharmacies will be paid in full by the Part D plan sponsor according to prompt payment requirements.
Action Required
Before January 1, 2025: Front desk staff should inform Medicare patients with high drug costs about the new Medicare Prescription Payment Plan enrollment opportunity this fall. No billing system changes required as pharmacies will be paid in full by Part D plan sponsors. Contact physician account executive at 1-866-918-1595 with questions.