The CareFirst BlueCross BlueShield Advantage DualPrime Medication Therapy Management Program (MTMP) helps you get the greatest health benefit from your medications by:
Who qualifies for the MTMP?
We will automatically enroll you in the CareFirst BlueCross BlueShield Advantage DualPrime Medication Therapy Management Program (MTMP) at no cost to if you meet the characteristics of at least one of the following within the two groups (Group 1 or Group 2) below. You may also qualify if meet other specific criteria determined by your plan.
You will be enrolled in the program automatically at no cost to you if these three conditions apply:
1. You take five or more Medicare Part D covered maintenance drugs, and
2. You have three or more of these long-term health conditions, and
3. You reach $4,935 in yearly (2022) prescription drug costs paid by you and the plan.
You will be enrolled in the program automatically at no cost if you are considered at risk for prescription drug abuse or misuse under the Drug Management Program (DMP).
Your participation is voluntary and does not affect your coverage. This program is free of charge and is open only to those who are invited to participate. The MTMP is not considered a benefit for all members.
What services are included in the Medication Therapy Management Program (MTMP)?
The MTMP provides you with a:
Comprehensive Medication Review (CMR)
A CMR is a one-on-one discussion with a pharmacist, to answer questions and address concerns you have about the medications you take, including:
The pharmacist will offer ways to manage your conditions with the drugs you take. If more information is needed, the pharmacist may contact your prescribing doctor. A CMR review takes about 30 minutes and usually offered once each year—if you qualify. At the end of your discussion, the pharmacist will give you a Personal Medication List of the medications you discussed during your CMR.
You will also receive a Medication Action Plan. Your plan may include suggestions from the pharmacist for you and your doctor to discuss during your next doctor visit.
Here is a blank copy of the Personal Medication List for tracking your prescriptions.
Targeted Medication Review (TMR)
A TMR is where we mail or fax suggestions to your doctor every three months about prescription drugs that may be safer, or work better than your current drugs. As always, your prescribing doctor will decide whether to consider our suggestions. Your prescription drugs will not change unless you and your doctor decide to change them.
Information about safe disposal of unused prescription drugs
How do I safely dispose of medications I don’t need?
The CareFirst BlueCross BlueShield Medicare Advantage MTM Program provides 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.
A drug take back site is the best way to safely dispose of medications. To find drug take back sites near you, visit this website and enter your location.
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.
Medications may be mailed to authorized sites using approved packages. Information on mail-back sites can be found at www.deatakeback.com.
You can safely dispose of many medications through the trash or by flushing them down the toilet. Visit this website to learn more about safe at-home disposal.
Follow these steps for medication disposal in the trash:
How will I know if I qualify for the Medication Therapy Management Program (MTMP)?
If you qualify, we will mail you a letter letting you know that you qualify for the MTMP. Afterward, you may receive a call from a partner pharmacy, inviting you to schedule a one-on-one medication review at a convenient time.
Will the Medication Therapy Management Program (MTMP) pharmacist be calling from my regular pharmacy?
Yes, the MTMP pharmacist may be calling from your regular pharmacy if your regular pharmacy chooses to participate in the MTMP as a service provider. You will be given the option to choose an in-person review or a phone review.
If your regular pharmacy does not participate in the program, you may be contacted by a Call Center pharmacist to provide your MTMP review, and ensure that you have access to the service if you want to participate. Call center reviews are conducted by phone.
Why is a review with a pharmacist important?
Different doctors may write prescriptions for you without knowing all the prescription drugs and/or OTC medications you take. For that reason, a pharmacist will:
How do I benefit from talking with a pharmacist?
How can I get more information about the Medication Therapy Management Program (MTMP)?
Please contact us if you would like additional information about our MTMP, or if you do not want to participate after being enrolled in the program. Our toll free number is 1-844-386-6762 (TTY: 711), 8 AM to 8 PM, ET, 7 days a week from October 1 through March 31 and 8 AM to 8 PM ET, Monday through Friday from April 1 through September 30.
Are all pharmacists in the CareFirst Medicare Advantage network also MTMP Pharmacists?
Not all pharmacists in the CareFirst Medicare Advantage network are MTMP Pharmacists. MTMP Pharmacists have finished a special training course in order to be able to provide these extra services. Ask your regular pharmacist if they participate in the MTMP.
Can I use my regular pharmacy and still visit an MTMP Pharmacist too?
Yes. Your MTMP Pharmacist is an added value of membership. You may continue to use any CareFirst Medicare Advantage participating pharmacy for your prescriptions.
Will I pay additional costs for using an MTMP Pharmacist?
No. These services are offered at no additional cost to you.
Do I need an MTMP Pharmacist?
While MTMP Pharmacists are available to all members, those with diabetes, high blood pressure, or other conditions treated with multiple medications may see greater benefit.
Can an MTMP Pharmacist save me money?
Yes. Similar medications that an MTMP Pharmacist may suggest to you can have large cost differences. Your MTMP Pharmacist can help you get situated with the least costly, most effective medications.
Will my doctor know if any changes need to be made to my prescriptions through the MTMP program?
Yes. Your MTMP Pharmacist may make recommendations to you and your doctor(s), but only your doctor can change your prescription.
Will I be required to use an MTMP Pharmacist?
No. Your MTMP Pharmacist is an added benefit of membership. They are there to help, but you are not required to utilize their services.
How do I get started with the MTMP?
Contact an MTMP Pharmacist in your area to schedule your Comprehensive Medication Review (CMR).