Medicare Prescription Payment Plan
This new payment option can help you manage your drug costs by splitting them into interest-free monthly payments throughout the year.
What is the Medicare Prescription Payment Plan?
The federal government now requires Medicare to offer a new payment option to help you manage out-of-pocket drug costs by spreading them across the calendar year. Starting in 2025, any member with Medicare Part D prescription drug coverage can use this payment option.
There’s no cost to participate in the Medicare Prescription Payment Plan, and you will not pay any interest or fees on the amount you owe. All plans with drug coverage offer this payment option and participation is voluntary.
How do I know if the plan is right for me?
This program can be helpful if you have high drug costs or spent more than $2,000 on your covered Part D prescriptions last year. You may also benefit from this plan if you opt in early in the new year. The more months you have in the program, the more your payments will spread out. Answer a few questions to see if this payment option may help you.
This payment option may NOT be the best choice for you if:
- Your yearly drug costs are low.
- Your drug costs are the same each month.
- You are considering signing up for the payment option late in the calendar year (after September).
- You don’t want to change how you pay for your drugs.
- You get or are eligible for Extra Help from Medicare.
- You get or are eligible for a Medicare Savings Program.
- You get help paying for your drugs from other organizations, like a State Pharmaceutical Assistance Program (SPAP), a coupon program, or other health coverage.
Please note: This payment option may help you manage your drug costs, but it does not save you money. If you are having trouble paying for your prescriptions, you may find help through these money-saving programs.
How it works
If you choose this payment option, you will no longer pay for your drugs at the pharmacy. Instead, you'll receive a monthly bill from Univera Healthcare to cover the cost of your eligible Part D prescriptions.
Step 1: Opt in
You can opt in opt in to the Medicare Prescription Payment Plan over the phone, by mail, or online. Log in to get started.
Step 2: Fill your prescriptions
Once we review your opt-in request, we will send you a letter confirming your participation in the Medicare Prescription Payment Plan. You can then fill your eligible Part D prescriptions through your pharmacy, but will no longer pay anything upfront.
Step 3: Pay monthly
Each month you will receive a bill for the prescriptions through Univera Healthcare. The total cost is divided into interest-free installments, which you pay over the remaining months of your plan year.
Your monthly bill
Prescription costs that you incur over the course of your plan year will be reflected in each monthly bill. This means your monthly bill may change until you hit your out-of-pocket maximum ($2,000 in 2025). Learn more about your monthly payments and see these helpful examples of calculations.
Cost of your prescriptions
Your monthly bill is based on what you would have paid for any prescriptions you pick up that month.
Plus previous balance
Then add your current month's bill to your previous month's balance.
Divided by remaining months
We divide this total by the number of months left in the year.
Future payments may increase when you fill a new prescription (or refill an existing prescription) because as new out-of-pocket costs get added to your monthly payment, there are fewer months left in the year to spread out your remaining payments.
Estimate my Payment
Your monthly bill is based on what you would have paid for any prescriptions you pick up that month.
Opt in to the Plan
You can opt in to the Medicare Prescription Payment Plan over the phone, by mail or online.
Prescription Payment Help
If you are having trouble paying for your prescriptions, you may find help through these money saving programs.
Estimate my Payment
Your monthly bill is based on what you would have paid for any prescriptions you pick up that month.
Opt in to the Plan
You can opt in to the Medicare Prescription Payment Plan over the phone, by mail or online.
Prescription Payment Help
If you are having trouble paying for your prescriptions, you may find help through these money saving programs.
Frequently Asked Questions
Visit Medicare Member Bill Pay Options to see how you can pay your bill online, by phone or by mail. If you opt in to the Medicare Prescription Payment Plan, you can view your statement online.
Every month we will send you an invoice with your payment amount and due date. If you do not pay your bill by the date listed, you will no longer be in the Medicare Prescription Payment Plan. If you are no longer participating in the Medicare Prescription Payment Plan, you will once again pay the pharmacy directly for your out-of-pocket drug costs.
We offer a grace period, but your coverage will end if full payment is not received by the end of that three-month period. To find out when your grace period ends, please call the number of the back of your member card. To voluntarily opt out of the Medicare Prescription Payment Plan, you can call the number on the back of your member card or log in and complete the opt-out form. See our Terms and Conditions for more details.
Please call the number on the back of your member card to opt out of the Medicare Prescription Payment Plan. You have the right to follow the grievance process found in your Evidence of Coverage should you disagree with your billing statements. Visit Grievances and Appeals for instructions on how to file a grievance.
We understand that sometimes you may need immediate access to a prescription due to an urgent situation. You can still opt-in to the Medicare Prescription Payment Plan within 72 hours of filling a prescription due to a life-threatening medical condition.
To request an urgent retroactive opt-in to the payment plan, please call 1-877-883-9577 (TTY 711) and select the pharmacy option.
If you have any questions about the Medicare Prescription Payment Plan or about your payment, we are here to help. Speak with one of our Customer Care Advocates by calling the phone number listed on the back of your member card.
Univera Healthcare is an HMO plan and PPO plan with a Medicare contract. Enrollment in Univera Healthcare depends on contract renewal. Submit a complaint about your Medicare plan at www.Medicare.gov or learn about filing a complaint by contacting the Medicare Ombudsman. Y0028_10520_C.
This page last updated 10-15-2024.
Modal for Terms & Conditions
Terms & Conditions
Terms & Conditions of the Medicare Prescription Payment Plan
Once you receive notice of your acceptance into the Medicare Prescription Payment Plan, your election request is effective. Once effective, the Health Plan will pay the pharmacy directly for your prescription drug claims. By opting into the Medicare Prescription Payment Plan, you agree to the following Terms and Conditions:
How you will be billed
The Health Plan will send you a bill each month. This Medicare Prescription Payment Plan bill will be separate from your plan premium if you have one. In the Medicare Prescription Payment Plan, each month you will pay your plan premium (if you have one) and you will get a bill from us for your prescription drugs (instead of paying the pharmacy). 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.
When payment is due
Payments will be due on the due date of each bill.
Acceptable payment methods
You can pay:
- Online by credit or debit card.
- Through the Health Plan’s mobile app.
- Through the mail by check or money order to Excellus Health Plan - Direct, Univera Healthcare - Direct, P.O. Box 5267, Binghamton, NY 13902-5267
- By setting up automatic payments through an electronic funds transfer
What happens if payments are missed
You will receive a reminder if you miss a payment. Your participation with us in this Medicare Prescription Payment Plan program may be terminated. Removal from the Medicare Prescription Payment Plan does not mean removal from your Medicare plan. Also, you will still be responsible for paying the total amount due after a failure to pay on the payment plan.
What if payments are made to the Medicare Prescription Payment Plan when premiums to your medicare advantage plan have not been paid
If you are delinquent on payment of your Medicare Advantage plan premiums, the Health Plan will apply payments made to the Medicare Prescription Payment Plan to your Medicare Advantage plan premiums.
Can I leave the Medicare Prescription Payment Plan?
You can leave the Medicare Prescription Payment Plan at any time. If you still owe a balance, you are required to pay the amount you owe, even though you are no longer participating in the program.
What happens if I leave or change Medicare prescription drug plans?
If you leave or change Medicare Prescription Drug Plans, your participation in the Medicare Prescription Payment Plan will automatically end with the Health Plan. If you still owe a balance to the Health Plan you agree to pay the amount owed. After opting out, you agree to pay any new out-of-pocket costs directly to the pharmacy.
How to address concerns with the Medicare Prescription Payment Plan
You have the right to follow the grievance process found in your Evidence of Coverage (EOC) as appropriate.
