Extra Help

• 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day, 7 days a week
• The Social Security Office at 1-800-772-1213, between 8 am to 7 pm, Monday – Friday. TTY users should call 1-800-325-0778
• Your state Medicaid Office

The Medicare Prescription Payment Plan (M3P) is a payment option that works with your current drug coverage to help you manage your out-of-pocket costs for drugs covered by your Part D plan by spreading them across the calendar year (January-December). 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. If you would like additional information, please visit pphealthplan.hlthcard.com.

To opt into the M3P plan, you can contact Member Services at 800-405-9681 to start participating in the Medicare Prescription Payment Plan anytime during the calendar year. Your plan will automatically renew your participation in this payment option every year, unless you change plans or contact your plan to opt out. You may also visit pphealthplan.hlthcard.com and click the ENROLL NOW button.

To opt out of the M3P plan, you can choose to pay off your remaining balance in one lump sum or continue to pay the monthly amounts. However, after opting out, you will go back to paying new prescription drug costs at the pharmacy. To opt out of the M3P plan, contact Member Services at 800-405-9681 or visit pphealthplan.hlthcard.com.

• Request help to obtain evidence of your proper copay level, or
• By submitting the existing evidence to Medicare on your behalf.

As a Part D plan sponsor, CMS regulations require us to have a process to help you determine if you are eligible for the Low Income Subsidy (LIS) when some of your documentation is missing or there is a conflict between the CMS system and your actual status.

Before you enroll, Provider Partners Health Plans will tell you what your plan premium will be with a low-income subsidy.

• Documentation from the facility showing Medicaid payments for a full calendar month
• Documentation from the state that confirms Medicaid payment to the facility for a full calendar month
• A screen print from State Medicaid showing the institutional status based on a full calendar month stay for Medicaid payment purposes

• A copy of valid State Medicaid Card showing eligibility dates
• Complete documentation of contact with State Medicaid verifying the Medicaid status (including date and time of contact, name, title, and phone number of the person contacted)
• Documentation that confirms active Medicaid status
• A printout from the State electronic enrollment file showing Medicaid status
• A screen print from the State’s Medicaid systems showing Medicaid status
• Other documentation provided by the State showing Medicaid status

These documents may be mailed to Provider Partners Health Plans’ main office:

Provider Partners Health Plans
PO Box 21063
Eagan, MN 55121