Did You Know That Your Medicare Part D Patients Are Not Restricted to the
Pharmacy Listed on Their Insurance Card?
Regardless of the suggested or preferred pharmacy listed on your Medicare patients’ prescription cards, any pharmacy that is willing and able to meet the Medicare Part D Plan’s terms and conditions must be considered “in-network.”1
Why Choose Onco360 to Assess Your Medicare Part D Patients?
- #1 in patient satisfaction with a Net Promotor Score of 92*
- 100% patient satisfaction with the customer service received from our pharmacists and team members*
- 120+ limited distribution medications available
There Are Two BIG Benefit Changes for Medicare Part D Patients in 2025
- Out-of-pocket prescription drug costs will be decreasing to a $2,000 maximum
This includes all part D prescription medications – brand and generic - New for 2025 – the Medicare Prescription Payment Plan (MPPP)
The MPPP is a new, voluntary payment option for Medicare patients to help manage out-of-pocket prescription drug costs by spreading them across the calendar year (January-December).
What does this mean for your Medicare Part D patients?
The changes for 2025 are aimed to make medications more affordable since the maximum out of pocket (OOP) has decreased to $2,000. However, since we know specialty medications can be very expensive, Medicare Part D patients will often reach their maximum OOP in January or early in the year. The new MPPP is designed to help spread the copays over the course of the year.
While this might sound like a great option to help lower monthly copay costs, enrollment in the MPPP may not be beneficial for the following patients:
If they received financial
assistance in 2024
If they are likely to receive financial
assistance in 2025
If they have limited income
We will review your Medicare patients’ medications along with their financial situation to assess the need for funding. Our OncoAdvocate Team® will source funding for patients who cannot afford the $2,000 out-of-pocket cost. Our goal is for the patients in need to have little to no copay and be able to avoid interruption in their much-needed treatment plan.
If your patient meets the financial assistance guidelines, we will work diligently to obtain funding with our proprietary Funding FastTrack Program.
- Patients are pre-screened by our OncoAdvocate Team®
- Once a patient is eligible for financial assistance, they are automatically enrolled and added to the program.
- When funding becomes available our OncoAdvocates work quickly to secure the appropriate funding.
Additionally, by 2025, certain Free Drug Programs will have changed their eligibility requirements:
- Maximum income limits have decreased
- May need to enroll for the new Medicare Prescription Payment Plan
Our team of over 30 OncoAdvocates will explore funding options and manage the entire process, reducing the administrative
tasks for our patients.
Let’s work together to help your Medicare patients in 2025!
How To Refer
E-Prescribe
Oncomed Dba Onco360 or
NPI# 1679618151
Call
Call 877-662-6633
*Third-party survey data provided by MMIT for Q4 2024. MMITnetwork.com
150.8.1 – Any Willing Pharmacy Requirement https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/R1PDB.pdf