The Medicare Prescription Payment Plan (MPPP) is an optional program that can help you manage your prescription payments. With this program:

• Costs for your covered Part D prescriptions are spread out over the plan year.
• You pay $0 at the pharmacy when you fill new or existing covered Part D prescriptions.
• You’ll receive a monthly bill from CarePlus with the amount you owe, your due date, and instructions on how to make a payment.

Note: This program can only help you manage your expenses—it can’t save you money or lower your drug costs.

The Medicare Prescription Payment Plan may help you manage your Part D prescription drug costs. Here are some tips to help you decide if this payment option might be helpful to you:

• If during the prior plan year, you filled a single prescription costing more than $600.
• If you have spent more than $2,000 on your covered Part D prescriptions.
• If you sign up early in the new plan year (the more months you have in the program, the more your payments will be spread out).

This payment option might not be helpful if you:

• Have prescription costs that are the same month to month.
• Have higher drug costs later in the year, as your balance would need to be paid off by year end.
• Are eligible for a Dual Eligible Special Needs Plan
• Qualify for cost savings programs
  
  • Extra Help/Low-income Subsidy (LIS)
  • Medicare Savings Program

For more information visit Medicare Resources or contact your local Social Security office. You can find your local Social Security office at https://www.ssa.gov/locator or by calling 800-772-1213, Monday – Friday, 8 a.m. – 7 p.m. local time. TTY users can call 800-325-0778.

To learn if you may be eligible for state and federal benefits, and for help applying, call the CarePlus Social Services team at 1-855-392-3900 (TTY: 711), Monday – Friday, 8 a.m. – 5 p.m.

Once you have enrolled in a 2025 Medicare Advantage Plan or Prescription Drug Plan after Oct. 15, you can opt in to the Medicare Prescription Payment Program at CarePlusHealthPlans.com/MPPP MyCarePlus.

Here you’ll find:

• Program information
• Frequently asked questions
• Balance and transaction history
• and more!

Please note that although you can opt in during the Annual Enrollment Period (AEP), this program becomes effective starting January 1, 2025.

If you have questions about the Medicare Prescription Payment Plan, please call our Member Services department at 1-800-794-5907 (TTY: 711). From October 1 - March 31, we are open 7 days a week, 8 a.m. to 8 p.m. From April 1 - September 30, we are open Monday - Friday, 8 a.m. to 8 p.m. You may leave a voicemail after hours, Saturdays, Sundays, and holidays and we will return your call within one business day.

Voluntary opt out of the Medicare Prescription Payment Plan

When you opt out of The Medicare Prescription Payment Plan, here’s what happens: 

• Going forward, you’ll pay your pharmacy directly for all your covered Part D drug costs. (This also applies to mail-order and specialty pharmacies).
• You will stop purchases added to your balance.
• You will continue to receive monthly bills for the amount incurred while in the program until your balance is paid.
• You also have the option to pay the balance in full at any time.

If you choose to participate in the program in the future, you simply opt in as you did before.

Do I need to opt in every year?

Your participation in the Medicare Prescription Payment Plan (MPPP) will end Dec. 31. To continue with the program in the new plan year, you must opt in again for a Jan. 1 start date.

In the Medicare Prescription Payment Plan (MPPP), you will get a monthly bill from CarePlus instead of paying for your covered Part D prescriptions at the pharmacy. For your first month, based on your start date in the program, your monthly payment could be as high as your total covered Part D drug costs for that month.

Your monthly bill is based on what you owe for any prescriptions you get plus any balance from the previous month, divided by the number of months left in the year. Your payment can change every month as you fill new prescriptions or refill existing ones. These will be added to your balance which may change from month to month.

Beginning in 2025, you won’t pay more than $2,000 for out-of-pocket costs for covered Part D drugs. This is true for everyone with Medicare drug coverage, even if you don’t opt into the program.

It doesn’t cost anything to participate in the program and you won’t pay any interest or fees on the amount you owe.

Note: Your monthly payment calculation is done every month to capture both your balance, and the remaining months left in the year.

If you don’t pay your monthly bill

If you don’t pay your past-due balance, here’s what you can expect: 

• You will continue to receive bills until your past-due balance is paid. 
• There is a 60-day grace period from your payment due date to your termination from the program.
• You will be ineligible to re-join the program until your past-due balance is paid.
• Once your past-due balance is paid, you can rejoin the program anytime.

Note: This only applies to your participation in the Medicare Prescription Payment Plan. Your Medicare drug coverage and other Medicare benefits won’t be affected, and you’ll continue to be enrolled in your plan for your drug coverage.

Here are some contacts that could help you decide if the program is right for you:

• Medicare— Visit Medicare.gov, or call 800-MEDICARE (1-800-633-4227), 24 hours a day, 7 days a week. TTY users can call 877-486-2048.
• State Health Insurance Program (SHIP)— Visit shiphelp.org to get the phone number for your local SHIP and to get free, personalized health insurance counseling.
• CarePlus— If you have questions about the Medicare Prescription Payment Plan, please call us at 1-800-794-5907 (TTY: 711). From October 1 - March 31, we are open 7 days a week, 8 a.m. to 8 p.m. From April 1 - September 30, we are open Monday - Friday, 8 a.m. to 8 p.m. You may leave a voicemail after hours, Saturdays, Sundays, and holidays and we will return your call within one business day.

If you are dissatisfied with any aspect of the Medicare Prescription Payment Plan, you have the right to ask CarePlus to reconsider our decisions through the grievance process.  You must submit your dispute within 60 calendar days after the incident or event initiating the grievance.

You may file an oral grievance by calling CarePlus Member Services at 1-800-794-5907 (TTY: 711). From October 1 - March 31, we are open 7 days a week, 8 a.m. to 8 p.m. From April 1 - September 30, we are open Monday - Friday, 8 a.m. to 8 p.m. You may always leave a voicemail after hours, Saturdays, Sundays, and holidays and we will return your call within one business day.

You may fax or mail your grievance request to: 

CarePlus Health Plans, Inc.
Attn: Grievance & Appeals department
P.O. Box 277810
Miramar, FL 33027
Fax number: 1-800-956-4288