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Medication Therapy Management Programs

Medication Therapy Management Programs

A large number of Medicare recipients also receive Part D coverage from Prescription Drug Plans (PDPs). Some of these people may need assistance with managing their programs and their medications. For this reason, all plans that offer Medicare prescription drug coverage (Medicare Part D) are required to have Medication Therapy Management (MTM) programs. MTM programs help reduce the incidence of medication errors during treatment.

MTM programs are relatively new. Formal guidelines and rules are still evolving, but the essential idea is this: You work with your doctor and your pharmacist to make sure you are using medications safely and effectively.

As part of an effort to improve patient outcomes, Medicare has encouraged providers to increase the number of beneficiaries who are deamed eligible for MTM programs. Stricter oversight of medication use by the Pharmacy and Therapeutic Committees (P&T) that manage standards on the use of drugs, therapies and drug related products is also being encouraged.

The basics of the MTM program are:

  • You make an appointment and meet one-on-one with a pharmacist.
  • During the meeting, all prescription medications, over-the-counter medications, herbal and dietary supplements that you take will be reviewed.
  • The pharmacist can answer your questions and help you understand more about your medications. He or she can also help you keep track of all the medications you currently take and provide you with a list you can take to your doctors.
  • A record of drug interactions or past problems with your medications can also be kept by the pharmacist.

Your Medicare prescription drug coverage plan determines whether you need an MTM program.

  • Typically, participants with chronic conditions are offered the program. For example, MTM programs can help people manage things like diabetes, asthma, high blood pressure, high cholesterol, heart disease, depression, arthritis and osteoporosis.
  • Working with a pharmacist in an MTM program can also be a good idea for participants who are beginning to experience problems with memory and making decisions.

Some Medicare prescription drug coverage plans contact members who seem to be most at risk for medication errors. They ask those members to use the plan's MTM program. If you think an MTM program would be helpful for you, contact your plan representative and ask.


Y0071_14_18421_U CMS Accepted 10/06/2013
39791WPMENMUB

Blue Cross Blue Shield Healthcare Plan of Georgia, Inc., is an HMO with a Medicare contract. Enrollment in Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. depends on contract renewal.
Blue Cross and Blue Shield of Georgia, Inc. is an LPPO plan and a PDP plan with a Medicare contract. Enrollment in Blue Cross and Blue Shield of Georgia, Inc. depends on contract renewal.

Blue Cross and Blue Shield of Georgia, Inc., and Blue Cross Blue Shield Healthcare Plan of Georgia, Inc., are independent licensees of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association.

Anthem Insurance Companies Inc. (AICI) has contracted with the Centers for Medicare & Medicaid Services (CMS) to offer Medicare Prescription Drug Plans (PDPs) noted above or herein AICI is the state-licensed, risk-bearing entity offering these plans. AICI has retained the services of its related companies and authorized agents/brokers/producers to provide administrative services and/or to make the PDPs available in this region.

Blue Cross and Blue Shield of Georgia, Inc. and AICI are independent licensees of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association.

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