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Medication Therapy Management Information

What is the Medication Therapy Management (MTM) Program?

The Medication Therapy Management (MTM) Program is a free service for members with multiple health conditions and who take multiple medicines. The MTM program helps you and your doctor make sure that your medicines are working to improve your health.
The MTM program is not considered a part of the plan’s benefit.

How can I learn more about the MTM Program?

For information about the MTM Program and how to obtain MTM service documents or to see if you qualify, you can call the number on your member ID card. Customer Service can help you from 8 a.m. to 8 p.m., seven days a week (except Thanksgiving and Christmas) from October 1 through February 14, and Monday to Friday (except holidays) from February 15 through September 30.

Who is eligible for the MTM Program?

To qualify for the MTM program, you must be eligible. Please see below for those details. If you qualify, you will be auto-enrolled into the program and the service is provided at no additional cost to you. You may choose not to participate in the program, but it is recommended that you make use of this free service.

You may qualify for the MTM Program if you meet all of these requirements:

  1. You have 3 or more chronic health problems.These may include:

    • Asthma
    • Chronic Heart Failure (CHF)
    • Chronic Obstructive Pulmonary Disease (COPD)
    • Diabetes
    • High blood fat levels
    • High blood pressure
    • Hepatitis C
  2. You take 8 or more daily medicines covered by Medicare Part D.
  3. In 2016, you spend $3507 or more per year on Part D covered medications. In 2017, you spend $3919 or more per year on Part D covered medications.

How does the MTM Program help me?

If you qualify for the MTM Program, you will be contacted and have the chance to speak with a highly-trained pharmacist or a pharmacist intern who is under the direct guidance of a pharmacist. During that call, the pharmacist or pharmacy intern will complete a comprehensive medication review of your medicines and talk with you about:
  • Any questions or concerns about your prescription or over-the-counter medicines, such as drug safety and cost
  • Better understanding your medicines and how to take them
  • How to get the most benefit from your medicine

What will I receive if I qualify for the MTM Program?

The Medication Therapy Management Program (MTMP) helps you understand your medications and use them safely. If you qualify for the MTM Program, you will receive:
  • A welcome letter that tells you how to get started.
  • A full medication review
    • You will have the chance to review your medicines with a highly-trained pharmacist or a pharmacist intern under the direct guidance of a pharmacist each year. This review will take about 20-30 minutes. During this call, any issues with your medicines will be discussed. The call can be scheduled at a time that works for you.
    • After you complete the full medication review, a summary is mailed to you. The summary includes a medication action plan with space for you to take notes or write down any follow-up questions. The action plan has steps you should take to help you get the best results from your medications.
    • You also will be mailed a personal medication list. It’s alist of all of the medicines that you take and the reasons why you take them.The medication list will help you keep track of your medications and how to use them the right way. View a blank copy of the personal medication list.
  • Ongoing targeted medication reviews
    • At least once every 3 months, your medicines will be reviewed, and you or your doctor will be contacted if there are recommendations for any changes in your medicines.
    • You may get a letter or a phone call for this review.

The MTM program is offered in collaboration with Express Scripts, Inc. and the Medication Management Center (MMC) at the University of Arizona.

Express Scripts, Inc. is a separate company that manages pharmacy services and benefits for Blue Cross and Blue Shield of Georgia and Blue Cross Blue Shield Healthcare Plan of Georgia.

The Medication Management Center (MMC) at the University of Arizona is an independent company that provides medication review services on behalf of Blue Cross and Blue Shield of Georgia and Blue Cross Blue Shield Healthcare Plan of Georgia.