Medication Therapy Management Program
We offer a free program to help our members with their medicines. It is called the Medication Therapy Management Program. Some members who take several medicines for different medical conditions may qualify for the program.
What is the purpose of the Medication Therapy Management Program?
The Medication Therapy Management Program helps make sure that you understand how to take your medicines correctly, and addresses medicine related problems such as side effects, use of higher risk medicines, and interactions between medicines. We can do this by talking to you about your medicines over the phone, and by periodically reviewing your pharmacy claims throughout the year. We will communicate with you and your doctor if we find any medicine related problems that we feel should be addressed.
Do you qualify for the Medication Therapy Management Program?
To qualify for the Medication Therapy Management Program, you must meet all three of the following criteria:
- You have been diagnosed by your doctors with at least three of the following medical conditions: diabetes, high blood pressure, high cholesterol, chronic heart failure, osteoporosis, asthma, COPD, depression, rheumatoid arthritis, and HIV.
- You have filled prescriptions for at least eight covered Part D medicines in the current calendar year.
- You must be likely to incur annual costs of $4,376 for all covered chronic Part D medications.
If you are eligible for the Medication Therapy Management Program we will automatically enroll you in the program and send you a welcome packet in the mail. The welcome packet includes a form you can return to us if you would like to have a Comprehensive Medication Review Phone Call with a Blue Medicare Advantage pharmacist.
What is a Comprehensive Medication Review Phone Call, and how can you request one?
We offer all of our members in the Medication Therapy Management Program an opportunity to review their medicines with a Blue Medicare Advantage pharmacist or other trained healthcare professional. We call this a Comprehensive Medication Review Phone Call. If you would like to have a call, please return the Comprehensive Medication Review Phone Call form included in your welcome packet. Then we will contact you to schedule a time that works best for you to have the call. If you have lost the form, you can call Customer Service and request a Comprehensive Medication Review Phone Call.
Please have a list of your medicines or your medicine bottles with you at the time of your call. This includes prescription medicines, over-the-counter medicines and supplements you are taking.
During the phone call we will review your medicines in detail. We can talk about how to best take your medicines, your costs, and any other problems you are having with your medicines. We can also help you set health goals and make plans to accomplish those goals. We are happy to address any questions or concerns you have about your medicines. Most calls take about 20 to 30 minutes.
After the call we will send you a written summary of the discussion. The summary has a medication action plan that recommends what you can do to make the best use of your medicines, with space for you to take notes or write down any follow-up questions. You will also get a personal medication list that will include all the medications you are taking and why you take them. If you would like a copy of a blank personal medication list please click here.
How can you get more information about the Medication Therapy Management Program?
If you would like more information about the Medication Therapy Management Program, please contact Blue Medicare Advantage Customer Service. If you misplace any letters that we have sent you, please contact Customer Service and request that we send another letter. Again, there is no cost to you to participate in the Blue Medicare Advantage Medication Therapy Management Program.
What if you are enrolled in Medication Therapy Management Program, but do not want to participate in the program?
If you receive a Medication Therapy Management Program welcome packet from us but do not wish to participate in the Medication Therapy Management Program, you can let us know by returning the Decline Participation form included in the welcome packet or by calling Customer Service.
If you previously told us that you did not want to participate in the Medication Therapy Management Program, but have changed your mind and now wish to participate, please Contact Us.
This program is not considered a benefit.