Download the New Medicare Prescription Payment Plan Likely to Benefit Notice (CMS Form 10882)
As a quick reminder, CMS Form 10882 is a Medicare notice that Plan Sponsors (via CMS directive) require pharmacies to provide patients if a prescription copay for a Medicare Part D claim exceeds $600. The requirement to distribute CMS Form 10882 started January 1, 2025, and is prompted by an Approval Message Code 056. The original expiration date on the form was July 31, 2025. CMS released an HPMS email advising pharmacies the original version of the form would continue to be valid for use after July 31, 2025 while comments on the proposed updates to the Medicare Prescription Payment Plan model materials were taken.
The latest update comes from another HPMS email dated January 20, 2026,
“…, the expiration date included on the Likely to Benefit Notice and Instructions has been updated to reflect that the Medicare Prescription Payment Plan model materials are approved through December 31, 2028.”
Pharmacies can find the most current version of CMS Form 10882 here, scrolling down to “Information Collection Requests (ICRs) for the Medicare Prescription Payment Plan”, and clicking “model materials (ZIP)” for the ZIP file of the notice in different languages and instructions. Be prepared for onsite auditors to ask for the form and the pharmacy’s policy for distributing.
PAAS Tips:
- See this month’s article, Year 2 of the Medicare Payment Prescription Plan (MPP or M3P): What We Learned for:
- Communications from PBMs regarding M3P noncompliance
- A review of adjudication responses for Approved Message codes
- Reminders about the M3P program
- Make sure the most up-to-date version of CMS Form 10882 is printing from your software system
- Download the New Medicare Prescription Payment Plan Likely to Benefit Notice (CMS Form 10882) - February 28, 2026
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