Medicare Prescription Payment Plan
- It spreads out-of-pocket drug costs across the calendar year (January to December).
- Starting in 2025, anyone with a Medicare drug plan or health plan with drug coverage can use this option.
- Your participation is voluntary.
- Participants will continue paying their premium (if applicable) and will receive a bill from their plan for prescription drugs instead of paying at the pharmacy.
- There is no cost to participate in this plan.
Important Considerations:
- This program can only help you manage your expenses.
- It cannot save you money or lower your drug costs.
- When filling a Part D prescription, you won’t pay at the pharmacy. Instead, you’ll receive a monthly bill from your health or drug plan.
- You are still responsible for the drug costs, even though payment is deferred to your monthly bill.
- For cost information before picking up a prescription, contact Leon Health, Inc. or ask the pharmacist.
Important Considerations:
- This option helps manage monthly expenses but does not reduce or lower drug costs.
- For cost-saving programs, check the section on “What programs can help lower my costs?” for options like Extra Help.
- This payment option may help manage monthly expenses, but it does not reduce or lower your drug costs.
- You’re most likely to benefit from participating in the Medicare Prescription Payment Plan if you have high drug costs earlier in the calendar year.
Best Timing:
- You can join at any time, but starting earlier in the year, will allow you more time to spread out your costs.
This payment plan may not be the best choice for you if:
- Your yearly drug costs are low.
- Your drug costs remain steady each month.
- You’re signing up late in the year (after September).
- You prefer not to change how you pay for your drugs.
- You are eligible for Extra Help, Medicare Savings Program, or other financial assistance programs (e.g., State Pharmaceutical Assistance Program or coupon programs).
- Leon Health, Inc.: Visit Leon Health website, or call our Member Services Department at 1-844-969-5366 (TTY: 711) from Monday – Sunday from 8 a.m. to 8 p.m., from October through March and Monday – Friday 8 a.m. to 8 p.m., April through September to get more information. If you need to pick up a prescription urgently, call our Member Services Department at 1-844-969-5366 (TTY: 711) to discuss your options.
- Medicare: Visit https://www.medicare.gov/prescription-payment-plan to learn more about this payment option and if it might be a good fit for you.
- State Health Insurance Assistance Program (SHIP): Visit shiphelp.org to get the phone number for your local SHIP and get free, personalized health insurance counseling.
You can also enroll in the program by filling out the online opt-in form: https://www.leonhealth.com/medicare-prescription-payment-plan-participation-request-form/
- If you sign up in 2024: Your participation will start January 1, 2025.
- During 2025: Starting January 1, 2025, you can start participating in the Medicare Prescription Payment Plan anytime during the calendar year.
Remember, this payment option may not be the best choice for you if you sign up late in the calendar year (after September). This is because as new out-of-pocket drug costs are added to your monthly payment, there are fewer months left in the year to spread out your payments.
Do I need to sign up every year?
Your participation in the Medicare Prescription Payment Plan (the program) will end on December 31. To continue with the program in the new plan year, you must opt-in again for a January 1 start date.
- When you get a prescription for a drug covered by Part D, Leon Health will automatically let the pharmacy know that you’re participating in this payment option, and you won’t pay the pharmacy for the prescription.Even though you won’t pay for your drugs at the pharmacy, you’re still responsible for the costs. If you want to know what your drug will cost before you take it home, call our Member Services Department at 1-844-969-5366 (TTY: 711) or ask the pharmacist.
- Each month, Leon Health will send you a bill with the amount you owe for your prescriptions, when it’s due, and information on how to make a payment. You’ll get a separate bill for your monthly plan premium (if you have one).
After Leon Health approves your participation in the Medicare Prescription Payment Plan, you’ll get a letter from Leon Health with information about how to pay your bill.
Option 1: Paying by check
Leon Health, Inc. will bill you on a monthly basis for the amount you owe. You may pay the plan for the amount you owe for the month. Send a check by mail to:
Leon Health, Inc.
c/o City National Bank of Florida
P.O. Box 527208
Miami, FL 33152-7208
You’ll get a reminder from Leon Health if you miss a payment. If you don’t pay your bill by the date listed in that reminder, you’ll be removed from the Medicare Prescription Payment Plan. You’re required to pay the amount you owe, but you won’t pay any interest or fees, even if your payment is late. You can choose to pay that amount all at once or be billed monthly. If you’re removed from the Medicare Prescription Payment Plan, you’ll still be enrolled in Leon Health, Inc.
Always pay your health or drug plan monthly premium first (if you have one), so you don’t lose your drug coverage. If you’re concerned about paying both your monthly plan premium and Medicare Prescription Payment Plan bills, go to the Section below on “What programs can help lower my costs?” for information about programs that can help lower your costs.
Call our Member Services Department at 1-844-969-5366 (TTY: 711) if you think Leon Health made a mistake about your Medicare Prescription Payment Plan bill. If you think Leon Health made a mistake, you have the right to follow the grievance process found in your Member Handbook or Evidence of Coverage.
You can leave the Medicare Prescription Payment Plan at any time by contacting our Member Services Department at 1-844-969-5366 (TTY: 711) from Monday – Sunday from 8 a.m. to 8 p.m., from October through March and Monday – Friday 8 a.m. to 8 p.m., April through September. Leaving won’t affect your Medicare drug coverage and other Medicare benefits. Keep in mind:
- If you still owe a balance, you’re required to pay the amount you owe, even though you’re no longer participating in this payment option.
- You can choose to pay your balance all at once or be billed monthly.
- You’ll pay the pharmacy directly for new out-of-pocket drug costs after you leave the Medicare Prescription Payment Plan.
If you leave Leon Health, Inc., or change to a new Medicare drug plan or Medicare health plan with drug coverage (like a Medicare Advantage Plan with drug coverage), your participation in the Medicare Prescription Payment Plan will end.
Contact your new plan if you’d like to participate in the Medicare Prescription Payment Plan again.
If you have limited income and resources, find out if you’re eligible for one of these programs:
- Extra Help: A Medicare program that helps pay your Medicare drug costs. Visit ssa.gov/medicare/part-d-extra-help to find out if you qualify and apply. You can also apply with your State Medical Assistance (Medicaid) office. Visit Medicare.gov/ExtraHelp to learn more.
- Medicare Savings Programs: State-run programs that might help pay some or all of your Medicare premiums, deductibles, copayments, and coinsurance. Visit Medicare.gov/medicare-savings-programs to learn more.
- State Pharmaceutical Assistance Programs (SPAPs): Programs that might include coverage for your Medicare drug plan premiums and/or cost sharing. SPAP contributions may count toward your Medicare drug coverage out-of-pocket limit. Visit go.medicare.gov/spap to learn more.
- Manufacturer Pharmaceutical Assistance Programs (sometimes called Patient Assistance Programs (PAPs)): Programs from drug manufacturers to help lower drugs costs for people with Medicare. Visit go.medicare.gov/pap to learn more.
Many people qualify for savings and don’t realize it. Visit Medicare.gov/basics/costs/help, or contact your local Social Security office to learn more. Find your local Social Security office at ssa.gov/locator/.
Leon Health, Inc.: Call Member Services to get more information.
Medicare: Visit https://www.medicare.gov/prescription-payment-plan, or call 1-800-MEDICARE (1-800-633-4227), 24 hours a day, 7 days a week. TTY users can call 1-877-486-2048.