Why you should sign up for a Medication Therapy Management program

If you take multiple prescription medicines per day, you know how confusing it can be to continuously remember how and when to take them. While smartphone apps and labeled boxes can sometimes help you manage the juggling act with relative success, one of the most effective ways to manage not just your doses—but your overall health­—is with Medication Therapy Management (MTM). MTM is a comprehensive program that ensures you are receiving the most effective medications and helps to reduce the risk of certain side effects and interactions. It can also reduce your out-of-pocket costs for medications. 

Best of all? It comes at no cost to Independence Blue Cross (Independence) members with pharmacy coverage. If you qualify, that means there’s no change to your insurance benefits, co-pays, Part D coverage, or available doctors and pharmacies. 

MTM: How It Works 

In an MTM program with PerformRx, an independent company, a specially trained pharmacist will work with you and your doctors to ensure that the medicines you’re taking deliver the best results. A pharmacist will speak with you over the phone and review every single medication you’re taking—from high blood pressure prescriptions to aspirin tablets to even vitamin supplements.

First, you’ll receive an introductory letter describing the program. Then, the pharmacist will schedule a medication consultation to review all the medications you’re taking and answer any questions you might have. 

During this review, the pharmacist may identify medications that may conflict with one another or medications with serious side effects. After talking with your doctor, you may learn that you are eligible for safer alternatives.

After the consultation with the pharmacist, you will be mailed a summary of your review. This contains an action plan for you, as well as a chance to ask the pharmacist any follow-up questions you may have. 

At least once every three months, your pharmacist will review your medicines and work with you and your doctors to determine if any changes are needed. A summary of your conversation will be mailed in a form called a Personal Medication List (PML). Additionally, if the pharmacist recommends changes to your medication regimen, it will be documented and sent to you in a Medication Action Plan (MAP), and your doctor will receive a notice of these recommended changes.  

Do I Qualify? 

You’re eligible for the MTM program if you have three or more of the following conditions:

• Atrial fibrillation and need anticoagulation medications
• Bone/joint disease (i.e., osteoporosis or rheumatoid arthritis)
• Chronic heart failure
• Cancer
• Diabetes
• Dyslipidemia
• High cholesterol
• High blood pressure
• Mental health conditions, such as depression
• Multiple Sclerosis
• Respiratory diseases, such as asthma or chronic obstructive pulmonary disease (COPD)

You can also qualify if you take six or more medications for chronic conditions, or you spend an annual amount of at least $4,255 in 2020 on Medicare Part D covered medications.

Is an MTM Program Right for Me? 

It could be, especially if you take more than a few medications or see several different health care providers. With the help of an MTM program, you’ll have a better understanding of how your medications fit into your overall health.

Call PerformRx at 1-888-349-0501 (TTY/TDD: 1-888-765-6351) Monday through Friday, 8:30 a.m. to 5:00 p.m. EST, to speak with a pharmacist about getting a comprehensive review of your medications. It’s simple and free—and it can be an important step toward staying healthy and active. 

PerformRx℠ is an NCQA and URAC-accredited pharmacy benefits manager that provides medication therapy management services and other best-in-class clinical solutions to help improve member health and well-being.