The Medicare Prescription Payment Plan, a new program that CMS requires all Part D plan sponsors to offer starting Jan. 1, 2025, shifts out-of-pocket payments from the pharmacy counter to a monthly payment to the plan. It’s understandable that patients and pharmacies would worry that after a required two-month grace period, a plan would attempt to collect the unpaid balance through the pharmacy counter, but it’s not allowed.
You can read more about the grace period and the collection of unpaid balances in the MPPP Part I Guidance. Any pharmacy that sees or suspects inappropriate cost sharing calculations after a patient is involuntarily removed from MPPP for missing the grace period can call in to complain at 1-800-MEDICARE or online to https://www.medicare.gov/my/medicare-complaint.
