How Firms Communicate about the New Medicare Prescription Drug Payment Plan

The Inflation Reduction Act of 2022 contains multiple measures aimed at lowering prescription drug prices for Medicare recipients and reducing federal drug expenditure. In part, the new Medicare Prescription Drug Payment Plan aims to assist patients who need high-cost specialty drugs, especially those with chronic conditions. Rather than paying an exorbitant cost in the first months of 2025, patients can spread out-of-pocket drug costs throughout the calendar year. The voluntary plan’s novelty requires firms to inform Medicare recipients of the new option through comprehensive resources. Below are examples of how leading firms within our Medicare Monitor coverage set have implemented educational content around this new payment plan:

Reaching Members Beyond Public Site Content

While most firms in our coverage set use their public sites to inform Medicare recipients of the new plan, a select number of firms rise above expectations by including informative tiles and overview pages behind-the-login. As covered in our November 2024 Medicare Monitor Update, Anthem BCBS and BCBS of Texas promote the plan on pharmacy-related pages throughout their member sites. For both firms, tiles and sections link to the SimplicityRX Medicare Prescription Payment Plan portal, enabling quick access to begin the opt-in process. Similarly, Humana features a dedicated Medicare Prescription Plan page on its member site. Highlighting the plan on member sites is particularly important to ensure that members who do not frequent the firm’s public site often are aware of their options.

Taking The Initiative to Implement FAQs

The beginning of any calendar year brings increased demand for patient support services. Ideally, firms should proactively finalize and continuously update FAQs, helping both users circumvent the inconvenient call process and firms avoid staffing issues from high call volumes. For example, Cigna lists information within expandable FAQs on its member site, enabling users to quickly access desired information without becoming overwhelmed by dense text. Notably, sites such as Florida Blue and Medicare.gov include sample payment calculations to demonstrate how the program calculates a monthly bill. By offering these comprehensive explanations, firms enable customers to envision how the plan applies to their individual situations and find solutions independently.

Helping Members Determine if the Plan is Right for Them

Given that the new plan most benefits patients who require high-cost drugs at the beginning of the year, it is essential for firms to provide customers with resources to determine if the plan will help them. Medicare.gov’s services are particularly robust, including a brief, interactive assessment for users to make an informed decision. As noted in our December 2024 Medicare Unique and Innovative Features report, interactive assessments add a level of personalization that encourages users to engage with their recommendations. On the other hand, UnitedHealthcare’s Medicare Prescription Payment Plan overview page features side-by-side comparison tiles with graphs that illustrate payment distribution, helping users clearly visualize the potential difference in their monthly payments.

A common misconception is that the new plan will discount drug costs overall rather than spread them out over the year; many sites explicitly state that this is not the case. However, firms conveniently help users looking for such programs to find the correct information. For example, firms such as Anthem BCBS and EmblemHealth supply links to existing programs that can help lower prescription costs like the Medicare Extra Help and Savings programs.

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