Ways to save on prescriptions
New 100-day prescriptions
Starting in 2026, you can now ask your doctor for a 100-day prescription (retail or mail order) for Tier 1 drugs. Prescriptions can be mail ordered from Express Scripts or Amazon.
Cap on Part D drug copays
In 2026, you'll never pay more than $2,100 for Part D prescription drugs. After you've reached the cap, all drug copays are $0.
$0 Tier 1 and Tier 2 prescription drug copays
If you qualify for Extra Help, you do not have a prescription drug deductible. Instead, you pay a set copayment or coinsurance for prescriptions. Tier 1 and 2 drugs are $0 and Tier 3-5* drug copays are up to $5.10 for generics and $12.65 for all other drugs. You will receive a letter in the mail that explains Extra Help, which is also known as Low-Income Subsidy (LIS).
If you do not qualify for Extra Help, you do not have a deductible for Tier 1 and 2 prescriptions. You'll pay the full cost for Tier 3-5* prescriptions until you reach your deductible.
Medicare Prescription Payment Plan (M3P)
The Medicare Prescription Payment Plan offered by Express Scripts is a payment option to help you manage your out-of-pocket drug costs. If you select this payment option, you'll get a bill from Express Scripts, the pharmacy benefit manager for Priority Health, for your prescription drugs. This means that instead of paying the pharmacy, you will be paying Express Scripts. Participating in this payment option is voluntary. It doesn't cost anything 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. This payment option might not be helpful for you if:
- You get Extra Help from Medicare.
- You qualify for a Medicare Savings Program.
- You get help paying for your drugs from other organizations, like a State Pharmaceutical Assistance Program (SPAP) or other health coverage.
- 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.
- You don't want to change how you pay for your drugs.
To sign up for this payment option, please complete the participation request form. You can also submit your request over the phone by calling Express Scripts at 1.866.845.1803, 24 hours a day, 7 days a week. TTY users can call 1.800.716.3231.
Questions?
If you have any questions, contact the Priority Health Customer Care team at 833.939.0983 (TTY 711).
From Oct. 1–Mar. 31, we’re available seven days a week from 8 a.m.–8 p.m. ET.
From Apr. 1–Sept. 30, we’re available Monday–Friday from 8 a.m.–8 p.m. and Saturday 8 a.m.–noon ET.
*Specialty drugs are limited to a 30-day supply.
H8379_NCMS400040062613P_C 10132025