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Medicare Prescription Payment Plan

A new payment option available to eligible Aspirus Health Plan Medicare Advantage members

Manage your out-of-pocket prescription drug costs

Beginning January 1, 2025, the Medicare Prescription Payment Plan is available to members with Part D coverage. This program will allow you to manage your out-of-pocket Part D prescription drug costs by spreading them out across the plan year instead of paying at the pharmacy. If you decide to participate, you’ll get a monthly bill from Aspirus Health Plan for your medications. You'll get a separate bill for your plan premium, if you have one. This payment option is free with no fees or interest charged under the program. Aspirus Health Plan is partnering with SimplicityRx to administer this program.

Who’s likely to benefit

You’re most likely to benefit from participating in the Medicare Prescription Payment Plan if you have high drug costs early in the calendar year. Although you can start participating in this payment option at any time during the year, starting earlier in the year (before September), gives you more months to spread out your drug costs. Beginning January 1, 2025, your out-of-pocket drug costs won’t exceed $2,000. Once you spend that amount each year (excluding Aspirus Health Plan's amount), you pay $0.

Check out this helpful tool on the Medicare website to answer a few questions and find out if you're likely to benefit from this payment option.

Sign up for the new program

If you’d like to participate in this program for 2025, you can sign up, beginning October 15, 2024, by:

  • Mailing your Participant Request Form to the following address:
    Aspirus Health Plan
    Mailstop: 1002
    MPPP Election Dept.
    13900 N. Harvey Ave
    Edmond, OK 73013

Sign up now

Beginning January 1, 2025, you'll be able to get into the member payment portal for the Medicare Prescription Payment Plan, if you've already signed up for the program.

Who’s eligible

Aspirus Health Plan members enrolled in the Essential Rx plan are eligible for the Medicare Prescription Payment Plan. You must be enrolled in a 2025 plan to qualify.

How Medicare Prescription Payment Plan works

You can learn more information about the process and what to expect with the Medicare Prescription Payment Plan fact sheet.

Sign up

The program will begin on Jan. 1, 2025. Once you sign up, Aspirus Health Plan will review your request and send you a letter confirming that the payment option has been added to your plan and how to pay your bill. You will need to join the program before you get your medication filled.

Fill your rx

When you get ready to fill a prescription drug covered by Part D, Aspirus Health Plan will automatically notify the pharmacy that you’re in the program. You won’t have to pay for your prescriptions during your visit at the pharmacy or through mail order.

Pay your bill

Aspirus will send you a bill each month that you can also access online. It will include the amount you owe on your prescriptions, when it’s due and how to pay. You'll pay for your plan premium in a separate bill, if you have one. See an example of how your monthly bill is calculated starting on page 6 in the fact sheet.

Opt out or program removal

Once you are signed up, you can opt out of the program by calling customer service. You'll still need to pay your account balance. If you miss a monthly payment, we will send a reminder. Failure to pay by the due date will result in removal from the program. You’ll still have Medicare Part D coverage.

Frequently asked questions

You can continue to access the member payment portal for the Medicare Prescription Payment Plan to view your balance and pay your bill online. You must have an Aspirus Health Plan online member account set up to access the payment portal. Aspirus Health Plan is partnering with SimplicityRx to administer this program.

The Medicare Prescription Payment Plan might help you manage your monthly expenses, but it doesn’t save you money or lower your drug costs. If you need assistance with lowering your drug costs, you may qualify for Extra Help, a Medicare program that helps people with limited income pay for prescription drugs, plan premiums and other health care costs. The amount of Extra Help you get will determine your total monthly premium as a member of our plan. To learn more about this program or if you qualify, call:

You can also find more information on the Medicare and Social Security Administration websites. All members with Part D coverage are eligible to participate in this payment option, regardless of income.

Yes, you will need to sign up every year to participate. If you leave your current plan or change to a new Medicare drug plan, your participation in the Medicare Prescription Payment Plan will end. Contact customer service if you change plans and would like to participate in the program again.

If you believe that Aspirus Health Plan has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability or sex, you can file an oral or written grievance.

To submit an oral grievance, please call the customer service number on the back of your member ID card. You can also send a written grievance by:

  • Mail to:
    Attn: Appeals and Grievances
    Aspirus Health Plan
    PO Box 51
    Minneapolis, MN 55440-9972
  • Email to cagMA@aspirushealthplan.com
  • Fax to 715.787.7325

You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint portal or by mail or phone at:

U.S. Department of Health and Human Services
200 Independence Avenue SW
Room 509F, HHH Building
Washington, D.C. 20201
1.800-368.1019, 1.800.537.7697 (TDD)

Check out more information on the process and how to follow up on the status of complaints, appeals and grievances.


If you already paid for your prescriptions at the pharmacy or through mail order, you may qualify for urgent election into the Medicare Payment Prescription Plan. To qualify for urgent election, you must meet the following criteria:

  • If you think that any delay in filling your prescription may jeopardize your life, health or ability to regain maximum function, including the 24-hour processing time for your request
  • If you request urgent retroactive election within 72 hours of the date and time the urgent claims are determined

You will receive reimbursement within 45 days once you’re admitted into the program. For more information call the customer service number on the back of your member ID card.


Need more information?

Contact customer service if you have questions.
You can also visit the Medicare website or call 1.800.633.4227 (TTY 1.877.486.2048), open 24 hours a day, seven days a week.