When you opt-in to the program, you will receive a monthly bill from McLaren Medicare for your pharmacy copays instead of paying them at the pharmacy. That bill is based on the out-of-pocket costs you normally would pay at the pharmacy, specialty pharmacy or by mail order.
As you get prescription services for Part D drugs, the dollars incurred will be added to your Medicare Prescription Payment Plan. You won’t make a copay at the pharmacy.
Let’s walk through a sample scenario for January and February where you filled three regular prescriptions, then added a fourth prescription in February.
Fill Date
|
Drug Cost
|
Copay
|
Pay at Pharmacy
|
Medicare Prescription Payment Plan Account Balance - Jan
|
1/2/2025
|
$500
|
$50
|
$0
|
$50
|
1/5/2025
|
$250
|
$25
|
$0
|
$75
|
1/10/2025
|
$750
|
$100
|
$0
|
$175
|
At the end of January, you have accumulated $175 in your Medicare Prescription Payment Plan account. This amount is divided by 12 equal payments for the rest of the year, making your monthly payment $14.58.
M3P Account Balance
|
Remaining Months
|
# Payments
|
Monthly Payment
|
$175
|
12
|
12
|
= $14.58
|
Fill Date
|
Drug Cost
|
Out of Pocket
|
Pay at Pharmacy
|
Medicare Prescription Payment Plan Account Balance - Feb
|
2/4/2025
|
$500
|
$50
|
$0
|
$50
|
2/5/2025
|
$250
|
$25
|
$0
|
$75
|
2/10/2025
|
$750
|
$100
|
$0
|
$175
|
2/15/2025
|
$400
|
$50
|
$0
|
$225
|
After February, you now have $225 from February, plus the balance from January of $160.42 ($175 - $14.58 payment = $160.42). Now, your new monthly payment is $35.04 calculated using the new balance of $385.42 ($160.42 + $225 = $385.42) divided by 11 remaining payments.
Running Balance
|
Remaining Months
|
# Payments
|
Monthly Payment
|
$385.42
|
11
|
11
|
= $35.04
|