Medicare Prescription Payment Plan


The Medicare Prescription Payment Plan, also called M3P and MPPP, is a new payment option to help you manage your out-of-pocket drug costs, starting in 2025. This new payment option works with your current drug coverage, and it can help you manage your drug costs by spreading them across monthly payments that vary throughout the year (January – December). This payment option might help you manage your expenses, but it doesn’t save you money or lower your drug costs.

If you are satisfied with your current Medicare Part D payment method, have consistent or low monthly drug costs, or receive assistance through programs like Extra Help (see details below), this option may not be the most suitable.

The prescription drug law sets a maximum limit of $2,000 on out-of-pocket costs for Medicare Part D in 2025. This means you won't spend more than $2,000 on Part D drugs out-of-pocket throughout the year, regardless of whether you opt into this payment plan.

How it Works

The Medicare Prescription Payment Plan is a voluntary payment option offered by all Medicare insurers with Part D plans. There are no fees or interest charges associated with the program. Participation in the plan does not reduce the amount you owe for your Part D prescriptions. Your cost-sharing responsibilities remain the same, but payment is more flexible.

  • You will continue to pay your Medicare Part D plan premium as usual. Always pay your monthly premium first to maintain your drug coverage.
  • If you enroll in the Medicare Prescription Payment Plan in 2024, your participation will begin on January 1, 2025. You can sign up at any time during the year starting January 1, 2025.
  • Once approved, you’ll receive a letter with instructions on how to manage your payments. When a pharmacy submits a claim for your prescription, they will be notified that you’re using this payment option.
  • Instead of paying at the pharmacy (including mail order and specialty pharmacies), you’ll receive a monthly bill based on the cost of your prescriptions and any outstanding balance, divided by the number of months remaining in the year. For details on how drug payments are calculated, refer to the Medicare Prescription Payment Plan Fact Sheet.
  • You remain responsible for all out-of-pocket costs for Medicare Part D drugs. For information on prescription costs, contact your pharmacist.

Monthly Bill

Timely payment of your monthly bills is crucial. Failure to make payments on time can result in:

  • Disruption of Prescription Services: Your medications may be delayed or interrupted.
  • Termination of Coverage: Persistent non-payment will cause your coverage to be terminated.

Savings with Medicare Extra Help Program

  • "Extra Help" from Medicare and help from your State Pharmaceutical Assistance Program (SPAP) and ADAP, for those who qualify, is more advantageous than participation in the Medicare Prescription Payment Plan.
  • Extra Help is a financial assistance program for Medicare beneficiaries with limited income and resources. It helps cover costs associated with Medicare Part D, including monthly premiums, copays, and coinsurance.
  • For free, personalized health insurance counseling, visit shiphelp.org to find the contact information for your local State Health Insurance Assistance Program (SHIP).
  • All members are eligible to participate in this payment option, regardless of income level, and all Medicare drug plans and Medicare health plans with drug coverage must offer this payment option.

Activate your Medicare Prescription Payment Plan

Visit https://m3p-form.optumrx.com/?cid=SHPM3P to start your request or call (844) 368-8729 TTY: 711 from 8 a.m. to 8 p.m. local time, 7 days a week.

Download Form

Send your request via mail to the address listed at the bottom of the form. Make sure to submit your requests with enough lead time to avoid disruptions in your prescription payments.

Opting out

When you opt out of the Medicare Prescription Payment Plan, the following will occur:

  • You will start paying your pharmacy directly for all covered Part D drug costs, including those from mail order and specialty pharmacies.
  • Purchases will no longer be added to your balance. 
  • You will continue to receive monthly bills for any remaining balance accrued while you were in the program until it is fully paid. 
  • You can choose to pay off the balance in full at any time.
  • If you decide to rejoin the program in the future, you can opt-in again as you did before.

Do I need to sign up every year?

Yes, your participation in the Medicare Prescription Payment Plan ends on December 31. To continue with the program in the new plan year, you must re-enroll for a January 1 start date.

Urgent Medicare Prescription Payment Plan Requests

Urgent requests for the Medicare Prescription Payment Plan can be made under certain circumstances. If you face an urgent need due to financial hardship or unexpected medical expenses, call (844) 368-8729 TTY: 711 from 8 a.m. to 8 p.m. local time, 7 days a week.

What if you think there’s been an error?

If you experience issues or disagree with our decision on the Medicare Prescription Payment Plan, You or your appointed representative can call (888) 278-6485 (TTY: (888) 279-1549) to file a grievance. For more on this process, refer to “What to do if you have a problem or complaint (coverage decisions, appeals, complaints)” in your Evidence of Coverage.

Additional Resources

Visit Medicare.gov/prescription-payment-planor call 1-800-MEDICARE (1-800-633-4227), 24 hours a day, 7 days a week. TTY users can call 1-877-486-2048 for additional information.

You can also review the program Fact Sheet for more information.

Sanford Health Plan and Sanford Health Plan of Minnesota have HMO and PPO plans with a Medicare contract. Sanford Health Plan D-SNPs have contracts with State Medicaid programs. Sanford Health Plan complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, or any other classification protected under the law. Medicare evaluates plans based on a 5-star rating system. Star Ratings are calculated each year and may change from one year to the next.


CMS ID Number: H8385_SHPMAWebsite_PY2025_ND_SD_IA, H3186_SHPMAWebsite_PY2025_MN H8967_DSNPWebsite_PY2025_ND

Last Updated On: 9.17.24 at 3:00 PM