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Manage Your Health With Medicare Medication Therapy

September 07, 2017

If you have multiple chronic health conditions, you might appreciate a little help managing your various prescriptions and their effects on you. One easy way to do this: Enroll in a Medicare prescription drug plan with a medication therapy management program. These programs are designed to help people manage a variety of chronic conditions such as diabetes, asthma, high blood pressure, high cholesterol, heart disease, depression, arthritis and osteoporosis.

What Medication Therapy Management Programs Can Do for You

All  Medicare plans that give you prescription drug benefits (Medicare Part D) must offer medication therapy management (MTM) programs. These programs help you work with your doctor and your pharmacist to make sure you are using your medications safely and effectively. And if you’re eligible, this service is free.

You May Qualify for Free Medication Therapy Management

You might be eligible to receive medication therapy management services — at no cost to you — if you have a Medicare drug plan and meet the criteria your plan sets. These criteria can vary by plan, but typically include:

  • How many medical conditions you have that need prescriptions to treat them.
  • How many prescription medications you take daily.
  • How much your medications cost on an annual basis.

Some  Medicare Part D Plans will auto-enroll you in their MTM program if they see you qualify. Medicare Advantage plans that provide prescription drug benefits, including Medicare special needs plans, might also offer you membership in their MTM programs.

If you take many medications for more than one chronic health condition and you’re not automatically enrolled in an MTM program by your plan, you should ask your plan about taking advantage of it.

Medication Therapy Management Program Started

An MTM program starts with a comprehensive review of all your medications by a pharmacist, who will meet one-on-one with you and go over:

  • What prescription medications you’re taking and how well they’re working.
  • Any over-the-counter medications or herbal and dietary supplements you take.
  • Whether your medications have side effects and how you’re tolerating them.
  • If there might be interactions between the drugs you're taking, or between drugs and food or other substances.
  • Whether your medicine costs can be lowered, such as with generic drugs.
  • Any other questions or issues you may have about your medications.
How a Medication Therapy Management Program Keeps Helping You

At the end of your comprehensive initial review, you’ll get a written summary of it plus:

  • An action plan for you to make the best use of your medications.
  • A personal medication list to take along on your doctor visits and help you keep track of all your medications.

Your MTM program will probably include ongoing medication reviews to help you continue taking an active role in managing your health. They may be monthly, quarterly or some other interval set by your plan. These typically check for changes with your prescriptions, harmful drug interactions, duplications in drug therapy, and other errors or gaps in care.

Remember, most MTM services will cost you nothing if you qualify. And although you are not required to use your plan’s program, it’s a smart way to make sure that all your medications are working together effectively to maintain and improve your health.

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A CONSUMER’S GUIDE TO HEALTH INSURANCE FOR PEOPLE ELIGIBLE FOR MEDICARE MAY BE OBTAINED FROM YOUR LOCAL SOCIAL SECURITY OFFICE OR FROM THIS INSURER.

Empire BlueCross BlueShield is an HMO plan with a Medicare contract. Enrollment in Empire BlueCross BlueShield depends on contract renewal. Services provided by Empire HealthChoice HMO, Inc. licensee of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield plans.

Services provided by Empire HealthChoice Assurance, Inc., licensee of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield plans. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year. You must continue to pay your Medicare Part B premium.

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