Medicare Prescription Payment Plan

Participation Request Form

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-December). This payment option may help you manage your expenses, but it doesn’t save you money or lower your drug costs.

This payment option might not be the best choice for you if you get help paying for your prescription drug costs through programs like Extra Help from Medicare or a State Pharmaceutical Assistance Program (SPAP). Call us at (800) 263-0067, 8:00 a.m. to 8:00 p.m. TTY 711.

Please note: From October 1 through February 14, Member Services is available 8:00 a.m. to 8:00 p.m., seven days a week. From February 15 through September 30, Member Services is closed on Saturdays and Sundays. Member Services is also closed on holidays. If you call when Member Services is closed, you can leave a voice message. An agent will return your call no later than the next business day.