Medicare Prescription Payment Plan

Do you need help with managing your prescription costs? The Medicare Prescription Payment Plan can get you the help you need with your out-of-pocket costs for your medications, starting in 2025. This is a new payment option that will help with your prescription costs by spreading them across monthly payments throughout the year.

The prescription drug law caps your out-of-pocket costs at $2,000 in 2025. This means you’ll never pay more than $2,000 in out-of-pocket drug costs in 2025.

Please note: This plan might help you manage your monthly expenses, but it doesn’t save you money or lower your drug costs.

You will still pay your plan premium if you have one. Then you will get a bill from your prescription plan. Anyone can participate in this plan. Your income is not a factor. All Medicare plans with prescription coverage have this plan available.

You have the choice to participate in this plan or not.

If you have higher prescription costs early in the year, this program can help. You will have more months left to pay for your prescriptions.

This payment option may NOT be the best choice for you if:

• Your yearly prescription costs are low.
• Your prescription costs are the same each month.
• You’re 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 prescriptions.
• 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 prescriptions from other organizations, like a State Pharmaceutical Assistance Program (SPAP), a coupon program, or other health coverage.

In 2024, for 2025: If you want to participate in the Medicare Prescription Payment Plan for 2025, contact Central Health Medicare Plan now. Your participation will start January 1, 2025.

During 2025: Starting January 1, 2025, you can contact your plan to start participating in the Medicare Prescription Payment Plan anytime during the calendar year.

Once you fill out your form, it will take about 10 days to get your confirmation.

If you need your medications right away. Central Health Medicare Plan will mark your request as urgent and work to get your election form active within 72 hours.

There are several ways that you can opt in to participate in this payment option:

• Complete the Medicare Prescription Payment Plan Participation Request Form and mail it to:
  Central Health Medicare Plan
  Attn: Membership Accounting Department
  PO Box 22800
  Long Beach, CA 90801-9945
• Fill out and submit the form directly through the MyCHPPortal :
• • Log into the portal
  • Go to “My Plan Resources”
  • Click the “Helpful Links” tab
  • Go to “Medicare Prescription Payment Plan”
  • Fill out the form and submit
• Call Member Services at (866) 314-2427, October 1 – March 31, 8 a.m. to 8 p.m. local time, 7 days a week, or from April 1 – September 30, Monday – Friday, 8 a.m. to 8 p.m. local time. TTY users can call 711, and a representative can help you complete the form over the phone.

We will review your participation request, and you will receive one of the following within 10 days:

• An approval with a start date of your participation
• A request for more information; or
• A denial of the request

You can opt out of the payment plan at any time by calling Member Services at (866) 314-2427, October 1 – March 31, 8 a.m. to 8 p.m. local time, 7 days a week, or from April 1 – September 30, Monday – Friday, 8 a.m. to 8 p.m. local time. TTY users can call 711. Leaving won’t affect your Medicare drug coverage and other Medicare benefits. Keep in mind:

• If you still owe a balance, you’re required to pay the amount you owe, even though you’re no longer participating in this payment option.
• You can choose to pay your balance all at once or be billed monthly.
• You’ll pay the pharmacy directly for new out-of-pocket drug costs after you leave the Medicare Prescription Payment Plan.

Read the Medicare Prescription Payment Plan fact sheet to learn:

• How your cost is calculated
• How to get your urgent prescription needs met
• What programs can help lower your costs

If you’re still unsure, you can visit Medicare.gov/prescription-payment-plan to see if this plan might be a good fit for you. You can also call Member Services at (866) 314-2427, October 1 – March 31, 8 a.m. to 8 p.m. local time, 7 days a week, or from April 1 – September 30, Monday – Friday, 8 a.m. to 8 p.m. local time. TTY users can call 711.

It is important to pay your monthly costs. There are implications for not making your payments. Read more in the terms and conditions.

If you need to file a complaint, call Member Services at (866) 314-2427, October 1 – March 31, 8 a.m. to 8 p.m. local time, 7 days a week, or from April 1 – September 30, Monday – Friday, 8 a.m. to 8 p.m. local time. TTY users can call 711.