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Medicare Prescription Payment Plan

What is the Medicare Prescription Payment Plan?

The Medicare Prescription Payment Plan is a voluntary payment option that works with your current drug coverage to help you manage your out-of-pocket Medicare Part D drug costs by spreading them across the calendar year (January to December). 

It’s part of the new prescription drug law, so all Medicare plans with drug coverage offer it to members at no cost starting January 1, 2025. 

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Will this payment option save me money or help me pay less for prescription drugs?

No. While it may help you manage your expenses, this payment option does not save you money or lower your drug costs. No matter what, you’ll pay the same total amount over the course of the year — it just changes when and how you pay. 

Looking for ways to lower your drug costs? 

First, check if you qualify for Medicare’s Part D Extra Help program (Low Income Subsidy or LIS). If you qualify for Extra Help, you’ll pay a $0 plan premium, $0 deductible, and $0 or low fixed copays for all covered Part D drugs. The rules recently changed and more people now qualify — so even if you’ve applied before, it’s a good idea to check again!

Apply for Part D Extra Help

If you don’t qualify for Extra Help, there may be other ways to lower your costs — like joining a Patient Assistance Program or asking your doctor about switching to similar, lower-cost drugs.

In 2025, all Medicare plans with drug coverage have a  $2,000 Part D out-of-pocket maximum. So, no matter what you choose, you won’t pay more than $2,000 for Part D drugs in 2025. 

How do I know if this payment option would help me?

It may be a good fit if:

  • You take one or more high-cost drugs
  • You typically have higher out-of-pocket drug costs early in the year
  • You expect to meet your plan’s $2,000 Part D out-of-pocket maximum this year
  • You have a large unexpected prescription drug bill that would be hard to pay all at once

It’s usually not a good fit if:

  • Your yearly drug costs are low
  • Your drug costs are the same each month
  • You don’t want to change how you pay for your drugs
  • You’re thinking about signing up late in the calendar year (after September)
  • You get help paying for your prescription drugs through programs like Extra Help from Medicare, a State Pharmaceutical Assistance Program (SPAP), or a coupon program

For some examples of yearly drug costs with and without this payment option, see page 4 here or watch this video:

Once I join, how does it work?

If you enroll in the Medicare Prescription Payment Plan:

  1. You pay $0 to the pharmacy when you fill your prescriptions. This includes all your Part D drugs from any pharmacy (including retail, mail-order, and specialty pharmacies). It does not include Part B, supplemental, or over-the-counter drugs.   
  2. Devoted Health sends you a bill each month that spreads out your out-of-pocket drug costs over the calendar year (January to December). If you also pay a plan premium or Late Enrollment Penalty (LEP), you’ll get a separate bill for your drugs. It’s important to pay both bills! 

For more details about how we calculate your monthly bill, see page 3 here.

Keep in mind: 

  • The Medicare Prescription Payment Plan is free to join — no fees, no interest. With or without it, you’ll pay the exact same amount for your prescription drugs over the course of the calendar year (from January to December). The only difference is when and how you pay that amount. 
  • Even though you won’t pay at the pharmacy, you’re still responsible for the cost of your drugs. To find out what your drug’s cost share will be before you take it home, call Devoted Health or ask your pharmacist. 
  • Your bill may change from month to month — sometimes by a lot. As you fill more prescriptions over the year, your payment may increase. This happens because there aren’t as many months left to spread out the new costs. 
  • If you don’t pay your bill for longer than 2 months, we’ll remove you from the Medicare Prescription Payment Plan. You’ll still be a member of your Devoted Health plan, but you’ll go back to paying out-of-pocket each time you fill a prescription. You’ll still owe the unpaid amount to Devoted Health, and you won’t be able to join the program with Devoted Health again until you pay it.
  • You can choose to join or leave the Medicare Prescription Payment Plan at any time.
    Sign up online at my.devoted.com/prescription-payment-plan, use the form on the next page, or call 1-800-DEVOTED and ask to join. To leave, just call and let us know when you’d like to leave.

How do I join the Medicare Prescription Payment Plan?

You can ask to join anytime. There are 3 ways to join:

How do I know when my payment plan will start?

It depends when we get your request to join. Once we get your request, we’ll process it within 10 days (before the plan year) or within 24 hours (during the plan year). When your request is approved, we’ll mail you a notice to let you know — and if it’s during the plan year, we’ll also tell you by phone. 

Can I include prescriptions in the payment plan if I already picked them up before joining?

It depends. Most of the time,  if you’ve already filled and paid for your prescription before signing up, you will not be able to include the cost of those drugs in the payment plan. 

There’s just one case where you can ask for an exception (called an Urgent Request): if waiting the usual timeframe for the prescription would be life threatening. You’ll need to make your request within 72 hours of when the pharmacy fills the prescription, which may be earlier than when you picked it up. 

  • If we approve your Urgent Request, we’ll pay you back within 45 days for your out-of-pocket costs for the urgent prescription — and for any other prescriptions you filled between then and when we approved your request.
  • If we do not approve your Urgent Request, we’ll let you know. We’ll also send instructions on how you can file a grievance (complaint) if you disagree with our decision. 

How do I leave the Medicare Prescription Payment Plan?

To leave, just call 1-800-DEVOTED and let us know. If you owe a balance, you still need to pay it even if you’re not in the program anymore. You can choose to pay it all at once or get a monthly bill for the rest of the year. 

What if I switch plans or leave Devoted Health?

Your participation in the Medicare Prescription Payment Plan will end. You’ll still owe any unpaid balance. If you’d like to join this payment option with your new plan, you’ll need to make a new request. This works the same way if you switch plans within Devoted Health or if you leave Devoted Health for another company. 

What if I want to file a complaint? 

Visit our prescription drug coverage rights page to learn how you can file a complaint (grievance) if there’s a problem with any aspect of your Devoted Health prescription drug coverage — including the Medicare Prescription Payment Plan.

What if I have more questions about the Medicare Prescription Payment Plan?