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Medication Therapy
Management Program

The Blue MedicareRx Medication Therapy Management Program (MTMP) helps plan members better understand their prescription drugs, prevent or reduce potential problems and get the maximum benefit from their drug regimen.

How does it work?

You will be invited to participate in a review of all of the prescription drugs and any other vitamins or herbal products you take with one of our pharmacists. The pharmacist will be able to answer any questions and address any concerns you have, and let you know ways to better manage your conditions with your drug therapy. If the pharmacist has a question or requires more information about a drug you take, he or she may contact your prescriber.

Print and fill out the Personal Medication List (PDF) to help you keep track of your prescriptions.

Who Qualifies for MTMP?

You will be automatically enrolled in this program if you:

  • Take eight or more Medicare Part D covered maintenance drugs
  • Have three or more of the following long term health conditions:
    • Asthma
    • COPD
    • Depression
    • Diabetes
    • Osteoporosis
    • Chronic Heart Failure
    • Cardiovascular Disorders such as High Blood Pressure, High Cholestrol, or Coronary Artery Disease
  • Have yearly prescription drug costs (paid by you and the plan) that reach $4,225 or more during 2020 or $4,376 or more during 2021

If you qualify:

  • The program is offered at no cost to you. Participation is voluntary and does not affect your Medicare drug coverage.
  • You will receive a letter in the mail stating you qualify for the Medication Therapy Management Program.
  • Within several weeks after receiving the letter, you may receive a call from a partner pharmacy. During this initial call, the pharmacy representative will schedule a one-on-one medication review between you and the pharmacist at a time that works for you.

What Services are Included?

The Medication Therapy Management Program includes two services:

Comprehensive Medication Review (CMR) During this service, you and the pharmacist will talk one-on-one about all of the prescription drugs and any other vitamins or herbal products you take – answering any questions and addressing any concerns you have. It usually takes about 30 minutes and is typically offered once per year. Additionally, the pharmacist will:

  • Talk about ways to better manage your conditions with your drug therapy. If he or she has a question or requires more information about a drug you take, they may contact your prescriber.
  • Give you a document called a “Personal Medication List” which will include all of the medicines that were discussed. You will also receive a document called “Medication Action Plan” summarizing your conversation. The “Medication Action Plan” may have suggestions from the pharmacist for you and your doctor to talk about during your next appointment.

Here is a blank copy of the Personal Medication List (PDF) to help you track your prescriptions.

Targeted Medication Review (TMR) This service includes messages and suggestions that are faxed or mailed from the Medication Therapy Management Program directly to your prescriber. The messages can identify other medicines that may be safer, or work better, than your current medicines. Your prescriber will have the final say as to the medicines you take. Your medicines will not change unless you and your doctor decide to change them. The Targeted Medication Review happens quarterly (four times per year).

Will the pharmacist that I talk to be my regular pharmacist?

You may be contacted by your regular pharmacy if they choose to participate in the Blue MedicareRx Medication Therapy Management Program as a provider of the service.

  • If your regular pharmacy calls, you may choose to meet with the pharmacist in person or you may review your medicines over the phone.
  • If your regular pharmacy does not participate in the program, you may be contacted by a pharmacist at a call center to review your medicines. If you want to participate, the call center pharmacist will make sure that you have access to the service. Medication reviews with call center pharmacists are conducted only over the phone.

Why is a review with a pharmacist important?

Get the peace of mind knowing that you are using your medications safely and effectively. Since different doctors may prescribe different medications, each doctor may not be aware of all the medications you take. A pharmacist will:

  • Review how your prescription and over-the-counter medications may affect each other.
  • Identify any medications that are causing you to feel bad, and offer suggestions to help.
  • Advise you how to take each of your medications so you get the most benefit from them.
  • Review opportunities to help you reduce your prescription drug costs.

How do I get more information about the Medication Therapy Management Program?

If you would like additional information about our Medication Therapy Management Program, or if you do not want to participate after being enrolled in the program, please call customer care. Contact Us

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  • Whether you have questions about your current membership, looking for more information about our plans, or to sign up for a new prescription drug plan, call us today!
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