FEP Medicare Prescription Drug Program (MPDP)
A Medicare prescription drug benefit for eligible members who qualify for Medicare Part A and/or Medicare Part B utilizing Medicare as their Primary Health Care coverage.
Medicare Prescription Payment Plan
If you have high prescription drug costs, you may benefit from a new program that works with your Medicare Part D coverage, including the FEP Medicare Prescription Drug Program (MPDP). The Medicare Prescription Payment Plan is a voluntary payment option that allows you to spread your out-of-pocket prescription costs across the calendar year (January–December). There’s no cost to participate in the Medicare Prescription Payment Plan.
Here’s how it works
Don’t pay at the pharmacy
When you fill a prescription for a Part D drug covered under MPDP, you won’t pay your pharmacy, including if they’re shipped using the Mail Service Pharmacy.
Instead, we will send you a bill each month separate from your health plan premium.
Pay your bill on time
You’re still responsible for your drug costs and it’s important to pay your bill on time. You’ll get a reminder from us if you miss a payment.
It’s important to pay your bill by the date listed in the reminder. Non-payment will result in removal from the Medicare Prescription Payment Plan.
If you’re removed from the Medicare Prescription Payment Plan, you’ll still be enrolled in MPDP.
How your bill is calculated
Your monthly bill is based on the Part D prescription drugs filled that month, plus your previous month’s balance divided by the number of months left in the year.
The prescription drugs filled that month
+ (plus)
Your previous month’s balance
÷ (divided by)
The number of months left in the plan year
Is this payment plan a good option for you?
Keep in mind that this payment plan is optional and might help you manage your out-of-pocket costs, but it won’t save you money or lower your drug costs. Here are two examples that may help you decide:
Example 1: John
- Takes a high-cost prescription drug
- Starts filling this prescription in January
- Reaches $2,000 pharmacy out-of-pocket maximum by April
- Typically pays more than $2,000 a year for prescription drugs
If he signs up for the payment plan in January:
- He can spread his prescription drug costs over the year
Example 2: Laura
- Takes mostly lower-cost generic drugs
- Monthly prescription costs are under $160
- Usually does not reach the $2,000 pharmacy out-of-pocket maximum each year
If she signed up for the payment plan:
- Her monthly payments would increase as she continues to pick up prescriptions with few months left in the year
If you have a similar situation, the Medicare Prescription Payment Plan may be a good option
If you have a similar situation, the Medicare Prescription Payment Plan is NOT a good option
Other things to consider
This plan might be beneficial if you have high prescription drug costs, but it won’t reduce your overall expenses. It’s not recommended if:
- Your yearly drug costs are low.
- Your drug 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 drugs.
- 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 drugs from other organizations, like a State Pharmaceutical Assistance Program (SPAP), a coupon program, or other health coverage.
Participating in the Medicare Prescription Payment Plan
How to opt in
If you want to participate in the Medicare Prescription Payment Plan, you can opt in here or by calling 1-888-338-7737.
Your participation will start January 1, 2025.
If you don’t have a MyBlue® account, you can complete the Medicare Prescription Drug Payment Plan request form and mail it to the address on the form.
How to opt out
You can leave the Medicare Prescription Payment Plan at any time here or by calling 1-888-338-7737.
Leaving won’t affect your MPDP coverage and other Medicare benefits.
A few things to 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 plan.
- 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.