Member Login
Website Logo

Find an AmaZing Pharmacy

Just enter your ZIP to get started.

The Inflation Reduction Act (IRA) & Medicare
Prescription Payment Plan (M3P)

If you aren’t familiar with the Inflation Reduction Act (IRA), experts say it will bring the largest change to the Medicare
Prescription Drug program (Medicare Part D) in nearly 20+ years.

A few changes have already taken place because of the IRA. For example, there is a maximum of how much you pay for insulin and most vaccines have $0 cost for members.

In 2025, you will see some of the largest impacts from the IRA. Here are a few things that are coming.

  • No more coverage gap (known as the donut hole).
  • An opt-in payment plan for high-cost drugs
    1. (This is known as Medicare Prescription Payment Plan or M3P).
    2. See below for more information on the M3P program.
  • A financial safety net, if your prescription drugs add up to $2000 in the year, you will pay $0 for your prescriptions for the remainder of the year.
Do you have your payment plan?

As of 2025, anyone with a Medicare drug plan or Medicare health plan with drug coverage (like Zing Health) can use this payment option for drugs covered by Part D. 

Suppose you have urgent prescriptions that need to be filled prior to the 24-hour time frame to process your request for enrollment into the Medicare Prescription Payment Plan. In that case, you can get retroactive coverage if you meet the following criteria:

  • Your health would have been jeopardized if your prescriptions were not filled sooner than the 24-hour time frame required to process your request.
  • You must submit your request for retroactive M3P election within 72 hours of the date and time the urgent claims were determined.
  • The Medicare Prescription Payment Plan is a new payment option that works with your current drug coverage to help you manage your out-of-pocket Medicare Part D drug costs by spreading them across the calendar year (January - December).
  • Starting in 2025, anyone with a Medicare drug plan or Medicare health plan with drug coverage (like Zing Health) can use this payment option for drugs covered by Part D.
  • All our Zing plans offer this payment option and participation is voluntary. In other words, you get to decide if this is the right choice for you.
  • If you select this payment option, each month you’ll continue to pay your plan premium (if you have one), and you’ll get a monthly bill from Zing Health to pay for your prescription drugs (instead of paying the pharmacy each time you pick up your prescriptions).
  • There’s no cost to participate in the Medicare Prescription Payment Plan, and you won’t pay any interest or fees on the amount you owe, even if your payment is late.
  • The program is available to anyone with Medicare Part D. Although it doesn’t change the total prescription drug costs, members with high drug costs earlier in the year are more likely to benefit from the program.
  • One extreme example is for a member who reaches the $2000 maximum out of pocket in January 2025 because they have extremely high drug costs. If the member opted into M3P program they would pay 12 monthly payments of $166.67 rather than $2000 in January and $0 for the rest of the year.
This payment option might NOT be the best choice for you if:
  • Your yearly drug costs are low.
  • Your drug costs are the same each month.
  • You’re considering signing up for the payment option late in the calendar year (after September).
  • You don’t want to change how you pay for your drugs.
  • You get or are eligible for Extra Help from Medicare.
  • You get or are eligible for a Medicare Savings Program.
  • You get help paying for your drugs from other organizations, like a State Pharmaceutical Assistance Program (SPAP), a coupon program, or other health coverage.

If you are identified as “likely to benefit” Zing will mail you a letter along with the Medicare M3P Fact sheet.

Likely to benefit means you have had or likely to have an out-of-pocket spending of $2000 or more from January through September of 2024.

There are 3 different ways you can opt-in to M3P. You can opt-in electronically, telephonically, and via paper forms.

No, the M3P program is voluntary, you only sign up if you choose to.

No, total out-of-pocket Medicare Part D drug costs will not change because of the program. Opting into the program will not affect or change your benefits.

The only difference is when you fill a prescription for a drug covered by Part D, you won’t pay your pharmacy (including mail order and specialty pharmacies). Instead, you’ll get a bill each month from your health or drug plan. Your monthly bill is based on what you would have paid for any prescriptions you get, plus your previous month’s balance, divided by the number of months left in the year. 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 your plan or ask the pharmacist.

  • Zing Health: Visit our website or call your plan to get more information. If you need to pick up a prescription urgently, call us to discuss your options.
  • Medicare: Visit 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.

Members can opt into the program prior to the beginning of the plan year, OR in any month during the plan year. Zing will have a process in place where you can opt-out of M3P. After opting out, the member will pay any new out-of-pocket costs directly to the pharmacy.

It is always important to pay your monthly bills. However, if a member does not pay the monthly bill, they can be removed from the M3P program. Zing Health would provide notification via letter to the member. The members would then start once again paying their copays at the pharmacy and be responsible for any unpaid balances.

You have the right to file a grievance or complaint.

Call customer care to submit Grievances at 833-829-6153
Fax: 866-217-3353
Beneficiary may submit a Grievance in writing to:
Grievance Department
P.O. Box 30016
Pittsburgh, PA 15222-0330

To get this material in other formats like large print, braille, or another language, contact your Medicare drug plan at the phone number on the back of your membership card. If you need help contacting your plan, call 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.