Medication Therapy Management Program

What is Medication Therapy Management?

BCBSAZ offers eligible members the opportunity to participate in a Medication Therapy Management Program (MTMP) at no cost. A pharmacist will review your medication list to make sure the medications are working for you. This free service assists enrollees with chronic conditions and helps them avoid medication errors, taking unnecessary medications, and finds cost saving alternatives. This is not a benefit for all members.

Who is Eligible to Participate?

The MTM Program is a voluntary service offered only to BCBSAZ enrollees who meet ALL of the criteria below:

  1. Have at least 3 of the conditions below:
    • Chronic Heart Failure (CHF)
    • Diabetes
    • Dyslipidemia (high cholesterol)
    • Hypertension (high blood pressure)
    • Chronic Obstructive Pulmonary Disease (COPD) or Asthma
  2. Take 8 or more Part D prescription medications regularly.
  3. The projected yearly cost for your prescription drugs is more than $4,696 in 2022 during the calendar year. (This includes what you pay and the plan pays)
  4. Identified as At-Risk under the Drug Management Program (DMP) with an active coverage limitation as of Jan 1, 2022. For more information about the Drug Management Program, click here DMP.

How Do I Participate?

If you meet the criteria, you will receive a welcome packet and a call to schedule an appointment with a pharmacist. You will also receive information on how to safely dispose of your medications.

What Services Are Included?

You will receive a comprehensive and targeted medication review by a pharmacist.

What is a Comprehensive and Targeted Medication Review?

A comprehensive medication review (CMR) is a phone or in-person conversation with the pharmacist or qualified provider to go over your prescription medications, over-the-counter (OTC) medications, herbal therapies, dietary supplements, and vitamins. This review typically takes about 20-30 minutes to complete and is done once a year.

During the conversation, the pharmacist may ask you how you take your medications and why you are taking them. You may also ask the pharmacists questions about your medications. The pharmacist will help determine if the medication is working well for you and may reach out to your doctor. If you or your caregiver are unable to do a CMR, your provider may directly help with your CMR.

A targeted medication review (TMR) is a quarterly review of your medications by a pharmacist. The pharmacist will reach out to your doctor by fax or phone call to recommend any suggestions to your doctor to make the medication safer or work better for you. The plan may also call you. No change will be done without your doctor’s approval.

Do I Have to Participate?

The program is voluntary. You may decline to participate; however, we highly encourage you to take advantage of this opportunity to better understand your medications. If you choose, you may opt out at any time by calling Pharmacy Services at 1-844-866-3735. TTY users should call 711.

What Will I Receive?

After having a call with the pharmacist, you will receive, by mail, the information below:

  1. Personal Medication List which will help you keep track of your medications and how to use them the right way. Your medication list will include the following information:
    • The name of the medication.
    • How you take it.
    • Why you take it.
    • The Prescribing Doctor.
  2. Personal Medication Action Plan based on your conversation with the pharmacist.
  3. A written description of what you and the pharmacist agreed will be communicated to your doctor.

Click here if you would like a blank copy of the Personal Medication List for your reference.

How Can I Safely Dispose of My Medications?

Below are some links of where you can find sites in your town to safely dispose your medications.

https://www.hhs.gov/opioids/prevention/safely-dispose-drugs/index.html
https://azdhs.gov/gis/rx-drop-off-locations/index.php