Definition: The Medicare Prescription Payment Plan (MPPP), also known as the “M3P” is a voluntary program designed to help Medicare beneficiaries manage out-of-pocket prescription drug costs. Starting January 1, 2025, this program allows individuals with a Medicare drug plan or a Medicare health plan (such as Medicare Advantage) with drug coverage to spread their annual out-of-pocket costs into monthly payments, rather than paying large upfront costs at the pharmacy at the time of prescription pickup. This means participants will pay $0 at the pharmacy for covered Part D drugs. Instead, Part D plan sponsors will bill participants monthly for any cost-sharing they incur while enrolled.1 For example, if a medication costs $1,000 over the course of the year and the patient has a deductible requiring them to pay $500 of that up front, the payment plan can spread those costs evenly across the year. This would result in monthly payments of about $83 for the medication instead of a large lump sum early in the year.
Pharmacies will be reimbursed in full by the Part D sponsor in accordance with Part D prompt payment requirements. This initiative, introduced under the Inflation Reduction Act of 2022, aims to enhance access to prescription medications and reduce burden for Medicare enrollees.2 While it does not reduce the total cost of medications, it can help beneficiaries better manage expenses by distributing costs over the year.
How it relates to quality-based care and pharmacists in these settings: The Medicare Prescription Payment Plan can support quality-based care by improving medication adherence and reducing financial barriers for patients. This payment plan can help ensure that patients continue necessary treatments without cost-related interruptions. By reducing medication nonadherence due to financial concerns, the program may contribute to better chronic disease management, lower hospitalizations, and improved overall health outcomes, which are key goals for value-based care models.
Patients can sign up for the MPPP through their Medicare plan at any time–either during open enrollment or by contacting their plan directly. To receive the most benefit from the MPPP program, patients should consider enrolling before January or before filling their first prescription.1 Involved organizations/oversight: The program is administered by the Centers for Medicare & Medicaid Services (CMS) and applies to Medicare Part D prescription drug plans. CMS will oversee implementation, and Part D plan sponsors will be responsible for offering beneficiaries the option to enroll in the program.1 Pharmacists are well-positioned to educate patients about the program, explain eligibility requirements, and guide them through the enrollment process.
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Contributing authors:
Amber Mercuro (Rollins), PharmD, BCACP
Clinical Ambulatory Pharmacist – Family Medicine
Dover Family Practice
Dover, NH