Frequently Asked Questions: Medicare Prescription Payment Plan (M3P)
Amplify Your Voice, Control Your Care
Navigating the healthcare system can be a complex journey. Accessia Health® strives to simplify this journey by offering comprehensive educational resources that help connect the dots and guide you towards informed health decisions.
Read on for more information and resources.
Ongoing Educational Support
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Navigating the healthcare system can be complicated and we can help with that. Join us as we provide the education and tools to amplify your voice and take control of your health care. With the right information, you are better equipped to make informed decisions for the care of yourself and your loved ones.
Click the button to view our upcoming webinars, and stay tuned for more opportunities to listen and learn.
Resources
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The following websites provide resources, support, and information for caregivers
- AARP – AARP’s Caregiving section on their website, has information about caregiving basics, care at home, care in nursing homes, financial and legal matters, life balance for caregivers, and how to find local resources.
- Aging Life Care Association – Promoting and leading the community of Aging Life Care Professionals® through our unique knowledge base, continuing education, professional development, and the highest ethical practices.
- Angel Aid – Connect with other Rare Caregivers, learn the tools of self-care, and be listened to without judgement.
- ARCH National Respite Network and Resource Center – Assists and promotes the development of quality respite and crisis care programs, helps families locate respite and crisis care services, and serves as a strong voice for respite in all forums.
- Canary Health – Offers free caregiver training for Veteran family caregivers
- Caregiver Action Network – CAN serves a broad spectrum of family caregivers. You can also speak with a caregiver expert for free; connect with them through email, chat and phone.
- Caregiving Resource Center – Provides key resources to help you better navigate caregiving.
- CaringBridge – To start a page and visit the Advice and Inspiration section for helpful articles on family caregiving.
- Elder Care Solutions – Offers a CarePath Tool that guides families to financially positive aging and care experiences.
- Family Caregiver Alliance – Offers quality information, support, and resources related to family caregiving. Also sign up for CareNav, a free online dashboard with personalized information that matches your unique caregiving needs.
- Finding a Foothold – Family caregiver group coaching and consulting services.
- Happy Healthy Caregiver – Caregiver podcast and newsletter for family caregivers.
- Help Hope Live– A nonprofit organization dedicated to raising money for medical bills and expenses through crowdfunding.
- Mental Health America – Offers resources for caregivers as well as informational webinars.
- My Pivotal Point for Caregivers – Group and 1-on-1 coaching sessions and membership with educational courses.
- National Alliance for Caregiving – The Alliance conducts research, does policy analysis, develops national best-practice programs, and works to increase public awareness of family caregiving issues.
- National Alliance on Mental Illness – Provides tools, education, and resources to support caregivers.
- National Genetics Education & Family Support Center – The Family Center encourages patient-centered outcomes by supporting individuals and families with genetic conditions to better engage with healthcare services.
- NORD – The National Organization for Rare Disease provides educational and financial resources to support your caregivers.
- WellMed – Offering you the support and education you need to help you take care of yourself and your loved one.
- Working Daughter – Membership site for female caregivers with careers.
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- Medicaid – The official site for Medicaid information
- Centers for Medicare & Medicaid Services (CMS) – The Medicare and Medicaid agency
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- Click here to use the Medicare insurance finder tool.
- Need Local Help With Medicare? Locate a SHIP Counselor
- Medicare part D updates: Part D Improvements | CMS
- Click here for Medicare FAQs
OTHER RESOURCES:- Medicare.gov – The official U.S. Government site for Medicare information:
- Medicare & You handbook
- Find out what Medicare covers
- Understanding Medicare Advantage Plans and Part D Enrollment Periods publication
- Information about premium payment
- Who to contact – Information by state on who to contact about:
- Your Medicare bill
- Getting Medicare, other health insurance, other benefits
- Complaints, appeals, and other Medicare rights
- Your health plan choices
- Medicare and the Marketplace
- Centers for Medicare & Medicaid Services (CMS) – The Medicare and Medicaid agency
- Medicare.gov page on M3P — https://www.medicare.gov/prescription-payment-plan
- M3P Wizard — https://www.medicare.gov/prescription-payment-plan/will-this-help-me
- Extra Help/Vaccines/Insulin Resources — https://www.cms.gov/inflation-reduction-act-and-medicare/resources-0
- Medicare.gov page on Insulin cap — https://www.medicare.gov/about-us/prescription-drug-law
- Drugs selected for negotiation and have negotiated prices — https://www.cms.gov/files/document/fact-sheet-negotiated-prices-initial-price-applicability-year-2026.pdf
- M3P technical memo on the methodology for calculating monthly payments — https://www.cms.gov/files/document/monthly-cap-cost-sharing-technical-memo-july-2023.pdf
PUBLICATIONS:
- How to Apply for Medicare Part B (Medical Insurance) During Your Special Enrollment Period
- Description: Learn the rules about the Medicare Part B Special Enrollment Period, how to apply and what happens if you don’t enroll in one.
- Medicare
- Description: Learn about Medicare hospital and medical insurance, who is covered, and how to apply.
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EXTRA HELP:
Anyone who has Medicare can get Medicare prescription drug coverage. Some people with limited resources and income may also be able to get Extra Help with the costs — monthly premiums, annual deductibles, and prescription co-payments — related to a Medicare prescription drug plan. The Extra Help is estimated to be worth about $5,300 per year.
- To determine if you are eligible for Extra Help, you will need to file an Application for Extra Help with Medicare Prescription Drug Plan Costs (Form SSA-1020).
- Apply for Medicare Part D Extra Help program – The Extra Help program helps people with limited income and resources lower or cut Part D costs.
- Annual Data for Extra Help with Medicare Prescription Drug Plan Costs
- Medicare Prescription drug costs at https://www.ssa.gov/medicare/part-d-extra-help
PUBLICATIONS:
- Understanding the Extra Help with Your Medicare Prescription Drug Plan
- Description: An overview of the Extra Help available to cover the costs of a Medicare prescription drug plan and a list of factors you should consider when comparing plans.
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Provided by the Social Security Administration Office, This Third-Party Disability Application Video Series provides instructions for people assisting members of the public with filing a disability application by paper or online. The four-part video series will walk you through the necessary forms and steps needed to file a complete third-party disability application for the person you are assisting.
The four-part video series includes:
- Video 1: “Helping Others Apply for Social Security Disability Insurance Benefits” – A guide through the important points of filing a disability application on someone’s behalf including the forms that you need to submit and best practices to follow.
- Video 2: “The Application Package” – The application package for filing a disability application online on someone’s behalf.
- Video 3: “Additional Information & Forms” – Additional information and forms for filing a disability application online on someone’s behalf.
- Video 4: “Tips & Best Practices” – Tips and best practices for filing a disability application online on someone’s behalf.
Video Lounge
Our video library is full of education and healthcare resources. Check back often as we are always adding up to date resources to meet all your education needs.
Learn the lingo.
Below are common health insurance terms. Please consult with your plan for specific plan benefits.
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Through the Basic Health Program, states can provide coverage to individuals who are citizens or lawfully present non-citizens, who do not qualify for Medicaid, CHIP, or other minimum essential coverage and have income between 133 percent and 200 percent of the federal poverty level (FPL). People who are lawfully present non-citizens who have income that does not exceed 133 percent of FPL but who are unable to qualify for Medicaid due to such non-citizen status, are also eligible to enroll.
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A percentage of costs that you pay for covered health care services usually after you’ve paid your deductible.
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A fixed dollar amount that you pay for a covered health care service usually after you’ve paid your deductible.
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The amount you pay for covered health care services before your insurance plan will pay for those services.
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A list of prescription drugs covered by your plan’s prescription benefits.
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Employer sponsored coverage is health insurance obtained through an employer and offered to employees and their dependents. It is also commonly called group coverage.
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Individual health insurance policies are not connected to employer sponsored coverage. Such policies may be purchased directly from an insurance company or through a health insurance marketplace for you and your family.
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Federal-state insurance program, and its guidelines vary from state to state. It serves low-income people of every age. Patients usually pay no part of costs for covered medical expenses; however, a small copayment is sometimes required.
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Federal health insurance program for: People who are 65 or older, certain younger people with disabilities, and people with end-stage renal disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD).
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The maximum amount that you have to pay for covered services in the plan’s coverage year.
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The amount you pay each month to have health insurance coverage.
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The providers, facilities, and pharmacies that your plan has contracted with to provide health care services.
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TRICARE is the health care program for uniformed service members, retirees, and their families around the world.
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