CMS Announces Plan to Let Beneficiaries Pay in Installments

August 24, 2023 — The Centers for Medicare & Medicaid Services (CMS) revealed new plans for a program that would allow Medicare members to pay for prescription drugs in increments over time.

This option must be offered at the beginning of 2025, and federal agencies believe that this plan could help customers avoid costly, upfront out-of-pocket drug costs.

Sponsors and pharmacies will be required to use this document for guidance to see which enrollees will benefit from the program as well as to understand the opt-in process and data collection that is necessary. The document also includes requirements for sponsors of Part D to reimburse pharmacies and how they should be handling monthly billing. 

Additional guidance from CMS will be received in early 2024, focusing on Medicare Part D enrollee outreach and education. CMS would also like to work on developing calculators to assist members in learning what their monthly payments could look like under this new program.

To download the original CMS document, click here.

For more information, contact us at (800) 689-2800 or contact@smsteam.net.

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