Spread out-of-pocket costs for treatment evenly through the year

In accordance with the 2022 Inflation Reduction Act, beginning in 2025 people with Medicare Part D plans have the option to pay out-of-pocket costs for prescription medications in monthly installments by opting in to the Medicare Prescription Payment Plan. Learn more: Understanding the Medicare Prescription Payment Plan

PAN’S POSITION

Out-of-pocket costs for prescription medications should be spread more evenly throughout the benefit year.  

For over a decade, the PAN Foundation advocated for and championed the ability for people enrolled in Medicare Part D plans to “smooth” their out-of-pocket prescription medication costs throughout the year. In fact, we helped develop the idea of smoothing, which is now known at the Medicare Prescription Payment Plan.

How will smoothing help Medicare beneficiaries access their medications?

The structure of Medicare Part D prescription drug plans concentrates out-of-pocket medication costs early in the benefit year. This benefit design can have a devastating impact on patients who face high cost-sharing at the beginning of the year for their essential medications. 

Most patients cannot afford large out-of-pocket expenses all at once or over a short period but can afford the total cost if spread out evenly throughout the benefit year. 

Now that the Medicare Prescription Payment Plan has become law, the PAN Foundation continues to serve as a key resource when it comes to increasing awareness, offering educational resources, and conducting research about the program. In addition, we have submitted letters and comments to the Centers for Medicare & Medicaid Services on the implementation and promotion of the Medicare Prescription Payment Plan. 

As a senior, I want cost predictability. I don’t want to stay up at night wondering if my next prescription is going to cost $800.

George Valentine, Texas, living with chronic lymphocytic leukemia