For information on how prescription drug plan premiums are billed and how you can pay your premiums please review the Part D Member Premium Billing Fact Sheet (PDF).
For questions regarding payment of your prescription drug plan premium, please call Member Services at 855-540-4744. TTY users should call 711.
Bank Withdrawal Pre-Authorization Form (PDF)
Part D Member Premium Billing Fact Sheet (PDF)
RRB Withhold Form (PDF)
If you're seeing a message that your browser's cookie functionality is turned off, it's possible that your browser's cookies are not enabled.
First-party cookies are cookies that are set by the site domain listed in the address bar.
Third-party cookies come from other domain sources that have items, such as ads or images, embedded on the page. Depending on your browser, you can control which types of cookies you allow.
For more information on Google Chrome, please see Google's Help Center.
For more information on Mozilla, please see Firefox Help for more instructions on enabling cookies.
For more information on Internet Explorer, please see Microsoft's Help Center on enabling cookies.
For more information on Safari, please see Apple's Help Center.
You're trying to view content for . You've selected as your state. You can close this dialog to view the content for .