Many members will pay less for their medications in 2025!
The SCAN formulary and your plan materials list the details of your pharmacy benefit—but they don’t show the big picture. Which is that many SCAN members will pay less in 2025 for prescription drugs.
Your pharmacy benefits still include:
- A comprehensive formulary with more than 1,400 drugs
- No Part D deductible in most plans
- $0 copay on 90% of the drugs our members take
And, in 2025 there will be:
- No more coverage gap (donut hole)!
- A new payment option to manage your drug cost if it’s just too high! See more information below on the Medicare Prescription Payment Plan.
- A $2,000 out-of-pocket limit on covered Part D drugs! Click here to find out how much your drugs may cost in 2025.
About the Medicare Prescription Payment Plan
The Medicare Prescription Payment Plan is a payment option that works with your current drug coverage. It helps you manage your out-of-pocket costs for drugs covered by your plan by spreading them across the calendar year (January through December).
The program is optional and costs you nothing. Keep in mind it does not lower your drug costs, but may help you manage your monthly expenses. Medicare has a helpful information page, including a video, that explains the program and helps you understand if you might benefit.
Learn more: What’s the Medicare Prescription Payment Plan?
See these FAQs for more information.
How do I know if the Medicare Prescription Payment Plan is right for me?
You’re most likely to benefit if you have high drug costs earlier in the year. You can start participating in the program at any time in the year, but starting earlier in the year, like before September, gives more months to spread out your drug costs.
SCAN’s pharmacy benefit partner, Express Scripts, has a handy tool that will calculate your potential medication costs through the Medicare Prescription Payment Plan.
Click here to use the Express Scripts calculator.
Still have questions? Call Express Scripts: 1-866-845-1803 (TTY: 1-800-716-3231)
Does the Medicare Prescription Payment Plan save me money on my drugs?
No. You still have to pay your full cost-sharing for your medications. However, the cost is spread out throughout the year. That’s why it’s most helpful to start earlier in the year. That way the cost is spread out over more months.
For help saving money on your prescriptions, go to Help with drug costs at Medicare.gov.
SCAN Member Services is also here to help. Please call us if you are having trouble paying for your prescription medications.
The $2,000 out of pocket is more than I can afford—can’t SCAN help?
Yes! The maximum out-of-pocket for prescription drugs in 2025 is $2,000. But with SCAN’s generous pharmacy benefits, you may pay much less.
Use our calculator to find out how soon you’ll hit the out-of-pocket maximum in 2025—and start paying $0 for your medications.
If I sign up for the Medicare Prescription Payment Plan, will my costs be the same every month?
Your payments might change every month, so you may not know what your exact bill will be ahead of time. Future payments might be higher if you fill a new prescription (or refill an existing prescription). That’s because as new out-of-pocket costs (your copays) get added to your monthly payment, there are fewer months left in the year to spread out the remaining payments.
How do I sign up for the Medicare Prescription Payment Plan?
Express Scripts is working with SCAN to help our members with the Medicare Prescription Payment Plan. Call them with questions or, if you’re ready to sign up, you can do so online or by mail.
Online: Express Scripts
By mail: Print one of these forms in your preferred language. Then, fill it out and mail it to the address listed on the form.
Who do I call if I have questions about this payment option or my payments?
Please call Express Scripts. As SCAN’s pharmacy benefit partner, they can answer your questions about the Medicare Prescription Payment Plan.
Call Express Scripts at 1-866-845-1803 (TTY: 1-800-716-3231).
Still have questions? Read the Medicare Prescription Payment Plan Fact Sheet. Choose your language:
There are no income eligibility requirements to participate in the Medicare Prescription Payment Plan (participation is voluntary). This payment option doesn’t lower your drug costs.
