Carrier "Smoothing Provision" Guidelines
Background
One of the new Medicare guidelines for 2025 that is causing some confusion is the The Medicare Prescription Payment Plan, also called the “Smoothing Provision.” It is a new payment option in the prescription drug law that works with current drug coverage to help manage out-of-pocket costs for drugs covered by a plan 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 a Medicare Advantage plan with drug coverage can use this payment option. All plans offer this payment option, and participation is voluntary.
If enrollees in a MAPD or PDP plan select this option, each month they’ll continue to pay their plan premium (if there is one), and will also get a bill from their health or drug plan to pay for prescription drugs (instead of paying the pharmacy). There’s no cost to participate in the Medicare Prescription Payment Plan.
Carrier Guidelines
Since all Medicare plans with drug coverage offer this provision, each carrier has published guidelines on how they will handle requests to participate in the program:
AETNA: Call Aetna at 1-800-282-5366 for questions and enrollment in the Medicare Payment Plan. Aetna also has a resource to explain how the program works:
BLUE CROSS & BLUE SHIELD OF NC: There is a resource in the back of each MAPD book (see link below) Agents are encouraged to have their clients interested in the program to call customer service directly.
DEVOTED HEALTH:
MAPD members can enroll in the program using one of the 3 options below:
- Call a Devoted Guide at 1-800-DEVOTED (1-800-338-6833) to request enrollment in the program.
- Text RXPlan to 86685. Cell phone must be the one registered with Devoted at enrollment to use this option.
- Enroll online my.devoted.com/prescription-payment-plan
Written instructions are attached in the form below:
HEALTHTEAM ADVANTAGE: There is a helpful web page dedicated to questions about the Medicare Prescription Payment Plan:
HUMANA: There is a helpful webpage dedicated to questions about the Medicare Prescription Payment Plan:
LIBERTY MEDICARE ADVANTAGE: Every new member gets a welcome packet and the enrollment details are included in that packet. Also, when a member or agent logs into the website, there is a member tab that lists the information on how to enroll as well.
UNITED HEALTHCARE:
Anyone enrolled with an effective date of 1/1/2024 or later can call member services to set up the Medicare Payment Plan: 1-866-272-1967
For questions on carriers not listed, or general information about the Medicare Prescription Payment Plan, contact one of our Agent Advisors.