We know managing drug costs is important to our members. The Medicare Prescription Payment Plan works with your current drug coverage, and it can help you manage your drug costs by spreading them across monthly payments that vary throughout the year, but it doesn’t save you money or lower your drug costs.

What’s the Medicare Prescription Payment Plan?

The Medicare Prescription Payment Plan is a payment option to help you manage your out-of-pocket drug costs. If you select this payment option, you’ll get a bill from Express Scripts, the pharmacy benefit manager for Priority Health, for your prescription drugs. This means that instead of paying the pharmacy, you will be paying Express Scripts.

Do I have to sign up for this payment option?

Participating in this payment option is voluntary. It doesn’t cost anything to participate in the Medicare Prescription Payment Plan, and you won’t pay any interest or fees on the amount you owe, even if your payment is late.

Will this payment option help me?

It depends on your situation. If you have high out-of-pocket drug costs, this payment option spreads out what you’ll pay each month across the year, so you don’t have to pay out-of-pocket costs to the pharmacy. This payment option might help you manage your expenses, but it doesn’t save you money or lower your drug costs. Visit medicare.gov/basics/costs/help/drug-costs to learn about programs that can help lower your drug costs.

How do I know if this payment option might not be right for me?

This payment option might not be helpful for you if:

• You get Extra Help from Medicare.
• You qualify for a Medicare Savings Program.
• You get help paying for your drugs from other organizations, like a State Pharmaceutical Assistance Program (SPAP) or other health coverage.
• Your yearly drug costs are low.
• Your drug costs are the same each month.
• You’re considering signing up for the payment option late in the calendar year.
• You don’t want to change how you pay for your drugs.

How will my costs work with this payment option?

When you fill a prescription for a drug covered by Part D, you won’t pay your pharmacy, including mail-order and specialty pharmacies. Instead, you’ll get a bill each month from Express Scripts. Your monthly bill is based on what you owe for any prescriptions you get, plus your previous month’s balance, divided by the number of months left in the year.

Note: Your payments might change every month, so you might not know what your exact bill will be ahead of time. Future payments might increase when you fill a new prescription or refill an existing prescription because as new out-of-pocket drug costs are added into your monthly payment, there are fewer months left in the year to spread out your payments.

How do I sign up for this payment option?

To sign up for this payment option, please complete the participation request form by clicking the link below.

Sign up

Are there other ways to sign up for this payment option?

You can submit your request over the phone by calling Express Scripts at 1.866.845.1803, 24 hours a day, 7 days a week. TTY users can call 1.800.716.3231. Additionally, you can download a printable version of the participation request form and submit it by mail.

• English form
• Spanish form

What if I have questions or am not sure if this payment option is right for me?

You can contact Priority Health Customer Service by calling us at 888.389.6648 (TTY: 711), from 8 a.m. to 8 p.m. Eastern time, seven days a week. You can also send a secure online message from your member portal account at member.priorityhealth.com by clicking on Get help in the top right corner of your screen. We’ll reply within two business days.