Medication Therapy Management Program

The CareFirst BlueCross BlueShield Medicare Group Advantage Medication Therapy Management (MTM) Program is all about you and your health. The MTM Program helps you get the most out of your medications by:

  • Preventing or reducing drug-related risks
  • Supporting good lifestyle habits
  • Providing information for safe medication disposal options

You will be enrolled in the CareFirst BlueCross BlueShield Group Advantage MTM Program if you meet one of the following:

  1. Have coverage limitation(s) in place for medication(s) with a high risk for dependence and/or abuse, or
  2. Meet the following criteria:
    • You have three or more of these conditions:
    • Alzheimer’s disease
    • Bone disease – arthritis (osteoarthritis, osteoporosis, rheumatoid arthritis)
    • Chronic congestive heart failure
    • Diabetes
    • Dyslipidemia
    • End-stage renal disease
    • HIV/AIDS
    • Hypertension
    • Mental health (depression, schizophrenia, bipolar disorder, chronic/disabling mental health conditions)
    • Respiratory disease (asthma, COPD, and other chronic lung disorders)
    • You take eight or more routine medications covered by your plan
    • You are likely to spend more than $ 1,623 in Part D prescription drug costs in 2025

Your participation in the MTM Program is voluntary and does not affect your coverage. This is not a plan benefit and is open only to those who qualify. There is no extra cost to you for the MTM Program.

If you qualify, we will mail you a letter. You may also receive a call to set up your one-on-one medication review.

In the MTM Program, you will receive the following services from a health care provider:

  • Comprehensive medication review
  • Targeted medication review

 

Comprehensive Medication Review

The comprehensive medication review is completed with a health care provider in person or over the phone. This review is a discussion that includes all your medications:

  • Prescription
  • Over-the-counter (OTC)
  • Herbal therapies
  • Dietary supplements

This review usually takes 20 minutes or less to complete. During the review, you may ask any questions about your medications or health conditions. The health care provider may offer ways to help you manage your health and get the most out of your medications. If more information is needed, the health care provider may contact your prescriber.

After your review, you will receive a summary of what was discussed. The summary will include the following:

  • Recommended To-Do List. Your to-do list may include suggestions for you and your prescriber to discuss during your next visit.
  • Medication List. This is a list of all the medications discussed during your review. You can keep this list and share it with your prescribers and/or caregivers.

Targeted Medication Review

The targeted medication review is completed by a health care provider who reviews your medications at least once every three months. With this review, we mail, fax, or call your prescriber with suggestions about prescription drugs that may be safer or work better for you. As always, your prescriber will decide whether to consider our suggestions. Your prescription drugs will not change unless you and your prescriber decide to change them. We may also contact you by mail or phone with suggestions about your medications.

Pharmacist on phone
 
 

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You may receive a call from a pharmacy where you recently filled one or more of your prescriptions. You can choose to complete the review in person or over the phone.

A health care provider may also call you to complete your review over the phone. When they call, you can schedule your review at a time that is best for you.

  • Trusted MTM Program partners: You may receive a call from the CVS Caremark Pharmacist Review Team, CareFirst Pharmacist Review Team, or the Outcomes Patient Engagement Team to complete this service.

Different prescribers may write prescriptions for you without knowing all the medications you take. For that reason, the MTM Program health care provider will:

  • Review all your medications
  • Discuss how your medications may affect each other
  • Identify any side effects from your medications
  • Help you reduce your prescription drug costs

By completing the medication review with a health care provider, you will:

  • Understand how to safely take your medications
  • Get answers to any questions you may have about your medications or health conditions
  • Review ways to help you save money on your drug costs
  • Receive a Recommended To-Do List and Medication List for your records and to share with your prescribers and/or caregivers

Please contact us if you would like more information about the CareFirst BlueCross BlueShield Group Advantage MTM Program or if you do not want to participate. Our number is 1-844-635-3406, Monday – Friday, 8AM – 6PM CST. (TTY users, call 711)

The CareFirst BlueCross BlueShield Group Advantage MTM Program is dedicated to providing you with information about safe medication disposal. Medications that are safe for you may not be safe for someone else. Unneeded medications should be disposed of as soon as possible. You can discard your unneeded medications through a local safe disposal program or at home for some medications.

  • Locating a community safe drug disposal site
    A drug take back site is the best way to safely dispose of medications. To find drug take back sites near you, visit the website below and enter your location: www.carefirst.com/safe-disposal-sites

    Some pharmacies and police stations offer on-site drop-off boxes, mail-back programs, and other ways for safe disposal. Call your pharmacy or local police department (non-emergency number) for disposal options near you.

  • Mailing medications to accepting drug disposal sites
    Medications may be mailed to authorized sites using approved packages. Information on mail-back sites can be found at www.deatakeback.com
  • Safe at-home medication disposal
    You can safely dispose of many medications through the trash or by flushing them down the toilet. Visit the following website first to learn what medications are safe to dispose of at home: https://www.hhs.gov/opioids/prevention/safely-dispose-drugs/index.html
  • Steps for medication disposal in the trash:
    • Remove medication labels to protect your personal information
    • Mix medications with undesirable substances, such as dirt or used coffee grounds
    • Place mixture in a sealed container, such as an empty margarine tub

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