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2022 Medicare with Medicaid (BlueCare Plus) Medication List (Formulary)
(Updated: 6/1/2022)
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Medication Therapy Management (MTM)
Medication Therapy Management (MTM) is a free program we offer eligible Medicare Advantage Prescription Drug plan members. It’s intended to help improve medication use, lower the risk of medication interactions and help members take medications as prescribed. The program includes a one-on-one consultation with a pharmacist or other qualified provider to review your prescription and over-the-counter medications. This is called a comprehensive medication review (CMR). It’s designed just for you and usually takes around 15-20 minutes. At the end of the review, you’ll get a copy of your list of medications and any topics you discussed.
During your personalized review, the pharmacist or other qualified provider will talk with you about:
- Whether your medications are working like they should
- Whether you’re having any side effects from your medications
- Whether there are lower cost medications on your plan’s covered drug list that you could discuss with your prescriber to see if they might be right for you
- Locations where you can safely throw away unused medications
MORE ABOUT MEDICATION THERAPY MANAGEMENT
To be eligible, you:
- Members in the Drug Management Program will be automatically enrolled.
- Must have three or more of these ongoing or chronic health issues:
- Asthma
- Chronic Heart Failure (CHF)
- Chronic Obstructive Pulmonary Disease (COPD)
- Depression
- Diabetes
- End-Stage Renal Disease (ESRD)
- High cholesterol
- High blood pressure
- Osteoporosis, and
- Take seven or more prescriptions, and
- Have spent $1,174 on medications in the past three months.
You don’t have to do anything. You’ll be automatically enrolled if you’re eligible. We’ll send you a letter to notify you. Once you’re enrolled, you’ll get the yearly comprehensive medication review, which includes an updated medication list and safe drug disposal tips. You’ll also get quarterly targeted medication reviews (TMRs) that look for changes in the drugs you take that might need to be addressed with your prescriber. We’ll send your prescriber a fax with suggested changes if necessary. Your MTM pharmacist or other qualified provider will also follow up with you, if needed.
You don’t have to participate in the MTM program if you don’t want to, and the MTM program doesn’t impact your plan Part D benefits, copays, coverage, or providers and pharmacies that may be in your plan’s network. You can decline certain parts of the MTM program and still stay enrolled, too.
Here are some of the resources to help you prepare for your comprehensive medication review:
Blank medication List
Drug Disposal Information
Questions? Call CSS Health at 1-877-450-37101-877-450-3710. They’re available Monday through Friday, 8:30 a.m. to 5 p.m. EST. Or give us a call at the number on the back of your Member ID card.
