Get free help with your medications! Talk to a pharmacist for free to review your prescriptions and learn how you could save money.

What is the Medication Therapy Management (MTM) Program?

Just like seeing a doctor, it's good to check your medications every year. MTM is a yearly check-up with a pharmacist. They help you understand why you take each medication, how well they work together, the best way to take them, and check for any problems as your health changes. MTM is not a plan benefit. It is a plan-required program by the Center of Medicare and Medicaid Services (CMS).

Our pharmacists are trained to help you get the best results from your medications. They know how and where to get your prescriptions at the best price.

How do I join?

You qualify for a free medication check if you have Medicare drug plan and:

Have 3 or more of these conditions: Alzheimer's, weak bones (osteoporosis), arthritis (osteoarthritis or rheumatoid), high blood sugar (diabetes), high cholesterol, kidney disease, HIV/AIDS, high blood pressure, ongoing trouble breathing (asthma/COPD), depression, or bipolar disorder;

AND

Regularly take 8 or more medications;

AND

Expect to spend over $1,623 on medications in 2025.

You may also qualify if you are a Medicare drug plan member who is considered “at-risk” by your doctor.

How do I start?

If you qualify, you will get a letter in the mail from Excellus BlueCross BlueShield asking you to join the MTM program. The letter will tell you how to join. You may also get a call from a pharmacist to make an appointment. If you can't find your letter, contact us to check if you can join.

Please call our Medicare Customer Care Advocates at 1-877-883-9577 (TTY 711), Monday – Friday from 8 a.m. - 8 p.m. ET. Joining MTM is optional and won't change your Medicare drug coverage.

What should I expect during my medication review?

Your review will take around 20 minutes but may be as long as 40 minutes if you have a lot of different medications. The pharmacist will go over everything, including prescriptions, vitamins, and supplements. They can answer any questions you have.

After the review, you will get a summary of your review and a medication list to help you track your medications and why you take them.

Working with your doctor

Throughout the year, the pharmacist will also do a targeted medication review to check for any problems with your medications. The pharmacist may call your doctor if there’s a problem. Your prescriptions will only change if you and your doctor agree to make a change.

Cost savings

Joining the MTM program may also help you save money by suggesting lower-cost medications or places with lower copays.

How has MTM helped people like me?

One drug plan member stopped taking his high blood pressure medication because it cost too much money. Our MTM pharmacist helped find a lower cost choice that would still work. The pharmacist spoke to the doctor, who agreed to change the prescription to the lower cost medication. The patient’s cost dropped to less than $10 and the new medication kept him healthy.

During the review, our MTM pharmacist found two (2) medications that worked the same way to treat the same problem. One of the medications was accidentally added after a hospital stay. The pharmacist called the doctor who had the member stop one of the medications. This helped to stop side effects from happening and saved a copay.

Our MTM pharmacist found out that a member was treating herself with a medication every day even though her doctor asked her to take it “as needed.” The member didn’t know how to tell when she needed the medication or not. The pharmacist gave her directions to follow, and she was able to take it when she needed to only. The medication lasted longer with less use and the member felt like she knew exactly what to do.

A member told the MTM pharmacist she stopped taking a medication when the tablets were too big to swallow. Because she stopped her medication, she was not getting better. The pharmacist called the doctor and asked to change the medication to a liquid. A few days later the pharmacist called to check on the member. She had filled the new prescription, was able to swallow the liquid and was feeling much better!

Contact Us

For more information on the MTM program, please call our Medicare Customer Care Advocates at 1-877-883-9577 (TTY 711), Monday – Friday from 8 a.m. - 8 p.m. ET. They are available to take your call every day including Saturdays and Sundays from 8 a.m. - 8 p.m. ET. from October 1 to March 31.

Excellus BlueCross BlueShield is an HMO plan and PPO plan with a Medicare contract. Enrollment in Excellus BlueCross BlueShield depends on contract renewal. Submit a complaint about your Medicare plan at www.Medicare.gov or learn about filing a complaint by contacting the Medicare Ombudsman. Y0028_9977_C.

This page last updated 12-01-2024.

 

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