Medicare Prescription Payment Plan

The Inflation Reduction Act (IRA) requires Medicare drug plans to offer the option of paying out‑of‑pocket drug costs in monthly payments instead of all at once to the pharmacy. The Medicare Prescription Payment Plan is OPTIONAL (patients must opt in) and effective January 1, 2025. Please review the additional information below about the program:

• Program participants will pay $0 to the pharmacy for covered Part D drugs after opting in with their Medicare plan.
• Part D plan sponsors will then bill participants monthly for any cost‑sharing they incur while in the program.
• The Part D sponsor will pay the pharmacy in full per Part D prompt payment requirements.
• Not all patients will benefit from the program. Patients with high cost‑sharing earlier in the calendar year are more likely to benefit from the program. Meanwhile, patients with low, stable drug costs won’t likely benefit from the Medicare Prescription Payment Plan.
• This payment option might help manage monthly expenses but doesn’t lower drug costs or save money overall.

By opting into this program with your Part D, it is important to note that this will affect your payments for all prescriptions, including prescriptions you receive from other pharmacies. This notice fulfills Sterling Specialty Pharmacy’s responsibility to notify you that you could likely benefit from the Medicare Prescription Payment Plan. Sterling Specialty Pharmacy does not assist with helping patients opt into this program.