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Created on September 26, 2024
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Transcript
Frequently Asked Questions
"I want to know more about the Medicare Prescription Payment Plan (M3P)"
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"Will the Medicare Prescription Payment Plan reduce my total out-of-pocket costs?"
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"Can I talk about M3P with members even if they haven't received their ANOC (Annual Notice of Change)?"
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"Is M3P a Wellcare initiative?"
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"Can a member use this program for medications that aren’t covered by their plan?"
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"How are my bills calculated if I enroll in M3P?"
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"Is this program required?"
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"How early can member opt in to Medicare Prescription Payment Plan?"
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"Is JANUVIA ORAL TABLET 100 MG covered under Value Script plan for 2025?"
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"When is the earliest date to request for Formulary Book and Pharmacy Directory?"
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"Is HEB Grocery a preferred pharmacy next year?"
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"Can I use rite aid pharmacy next year?"
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"What are the ways on how the member can opt-in to M3P?"
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Home
"As I get those prescriptions, instead of paying the full amount at the pharmacy I would pay $0 and then receive a bill of the following month?"
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"Who are the members likely to benefit from M3P, and how will they be notified?"
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"Can you discuss M3P details if the member has not received their ANOC?"
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"Who are the members likely to benefit from M3P, and how will they be notified?"
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Home
"Can you discuss M3P details if the member has not received their ANOC?"
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Frequently Asked Questions
Yes, it is a standard pharmacy
Members may have already seen the program on billboards, ads, or online. So, you can still discuss it with them.
Yes, you can!
It lets you pay your out-of-pocket prescription drug costs in monthly payments over the plan year, instead of paying everything at once when you pick up your medication.
The Medicare Prescription Payment Plan is a program created by the Inflation Reduction Act.
Yes, you'll pay $0 at the pharmacy when you go to pick up your prescription and later receive a bill.
To understand the specifics of how the program will work with your medications and timing, I can transfer you to Express Scripts or provide the phone number for you to further discuss this new program.
When a member calls before October 15 and wants to enroll, they should contact ESI. CSAs must provide the Express Scripts M3P Member Line: 833-750-9969. Starting October 15, members can also enroll through the ESI website at www.express-scripts.com/mppp.
Members can start enrolling into the program by October 15.
It just spreads the payments for your covered prescriptions throughout the year.
No, this program doesn’t lower your overall costs.
Yes, it's covered. It falls under tier 3 with a quantity limit of 30 tablets per 30 days.
Yes, HEB is part of preferred pharmacy
But delivery will be October 15, 2024, as long as they receive the ANOC
Members can request as early as September 1st until the 30th
Member to log in towww.express-scripts.com and access the M3P portal to opt-in
No, only medications that are covered on their plan’s formulary are included in this program.
For example: Instead of paying $500 a month for four months to reach the $2000 out-of-pocket max, you could pay around $180 a month for the rest of the year. But this amount can change based on your prescriptions.Note: ESI can help explain the estimated costs per month based on the member’s medication usage.
No, joining M3P is optional. But it could be helpful if you have expensive medications that are covered.
No, it’s a program offered by Medicare, not Wellcare.
The amount can change based on the meds you fill or refill. Also, your payment for the prescription plan is separate from your monthly premiums.
Your monthly bills depend on how much you owe for your prescriptions, divided by the number of months left in the year.
Yes, we can discuss M3P to the member
Members with high out-of-pocket spend between January to September 2024.
Notification may be via email or mail before 12/7. At point of sale if filing a prescription over $600 in 2025
Members with high out-of-pocket spend between January to September 2024.
Notification may be via email or mail before 12/7. At point of sale if filing a prescription over $600 in 2025
Yes, we can discuss M3P to the member