A NEW WAY TO MANAGE PRESCRIPTION COSTS MEDICARE SMOOTHING PROGRAM:
• Improve Health Outcomes: When medications are affordable, people are more likely to take them as prescribed. • Ease Financial Stress: No more scrambling to pay a big bill in January. • Help With Budgeting: Monthly payments fit better into most people’s budgets. And if you’re wondering, “Is there a catch?” the answer is no — unless you fail to pay your monthly bills. In that case, you could be removed from the program, so timely payments are essential.
Coming in 2025, Medicare’s “smoothing” option is here to make life easier for millions of Medicare beneficiaries.
If you’ve ever felt like Medicare’s prescription drug costs hit harder than an unexpected pothole, good news is on the horizon. Starting Jan. 1, 2025, Medicare’s new “ smoothing ” program — officially called the Medicare Prescription Payment Plan (MPPP) or M3P — will allow you to spread your out-of-pocket costs evenly throughout the year. No more starting January with a hefty bill that feels like it belongs in a blockbuster medical drama! Here’s what you need to know to get ready for this exciting change. WHAT IS MEDICARE SMOOTHING? Medicare smoothing is a voluntary program designed for Part D enrollees. Instead of paying your prescription drug costs as they arise — often in large sums early in the year — you can now spread those expenses over 12 manageable monthly payments. Here’s the catch: It doesn’t reduce your overall costs; it just spreads them out evenly. Think of it as a payment plan for your prescriptions, helping you avoid financial whiplash.
HOW TO SIGN UP Signing up is straightforward. You can:
• Call your plan’s toll-free number. • Sign up online through your plan’s website. • Fill out a paper form. • Opt-in during the enrollment process.
Details about the program will also be available on Medicare.gov and in the “Medicare & You” handbook.
HOW DOES IT WORK?
WHAT’S THE $2,000 CAP? Smoothing isn’t the only change coming in 2025. The Inflation Reduction Act introduces a $2,000 annual out-of-pocket cap for Part D drugs. That means no one will pay more than $2,000 for prescriptions in a year. Combine that with smoothing, and you’ll have a prescription plan that’s both affordable and predictable. WHY IT MATTERS Imagine this: You’ve just been prescribed an expensive medication, and the pharmacy tells you it’ll cost $3,000 upfront. In the past, that might have meant delaying treatment or scrambling for funds. With smoothing, you’d only pay a manageable monthly amount — letting you focus on your health instead of your wallet. FINAL THOUGHTS The Medicare smoothing program is a game-changer for beneficiaries navigating the costs of prescription drugs. It gives you more control over your finances and improves access to life-saving medications. So, if you opted in on Oct. 15, 2024, you can take advantage of this new option during Medicare Annual Enrollment Period. Because managing your prescriptions shouldn’t feel like climbing Mount Everest — now it’s a smooth ride all the way. Have questions about how this affects you? Let’s chat — help is just a phone call away! Speak with a licensed insurance agent professional.
Opting in is simple:
1. During Annual Enrollment: Starting Oct. 15, 2024, you can sign up for the smoothing program through your Part D plan. 2. Automatic Coordination: Once enrolled, your plan works with the pharmacy to handle your cost-sharing payments. Instead of paying at the counter, you’ll get a monthly bill from your plan sponsor. 3. Monthly Caps: CMS (Centers for Medicare & Medicaid Services) calculates a monthly maximum cap to ensure predictable payments.
For example, if your out-of-pocket costs for the year are $2,000, you’d pay about $167 per month under the smoothing program.
WHO CAN JOIN? Anyone enrolled in Medicare Part D can participate in the smoothing program. Whether your annual prescription costs are high or low, you’re eligible. However, the program is particularly beneficial for people with significant upfront drug expenses — like those on specialty medications. WHY IS SMOOTHING A BIG DEAL? For years, beneficiaries on Medicare have faced a frustrating problem: high upfront costs at the beginning of the year. Research shows these large bills often lead to skipped prescriptions or delayed treatments. By breaking those costs into smaller, predictable amounts, the smoothing program aims to:
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