What is Medication Therapy Management?

Who is this for?


If you take a lot of medications, you might qualify for a program that helps you manage your prescriptions. Learn more about it here.

When you have chronic health conditions like diabetes, COPD, rheumatoid arthritis, Alzheimer’s disease or heart failure, prescription drugs can be a big part of your life.

The Medication Therapy Management program helps make sure the prescription drugs you're taking are working for you. It also helps us identify any potential problems.

If you're eligible for this program, our team of pharmacists and qualified pharmacy staff will work with you one-on-one. They’ll make sure you get the best results from the prescription drugs you take.

You're eligible if you meet at least one of the two following qualifications:

  1. Be an At-Risk Beneficiary as defined by the BCBSM/BCN internal drug management program
  2. Meet ALL of the following criteria: 
    • Have at least three qualifying chronic health conditions such as diabetes, COPD, rheumatoid arthritis, Alzheimer’s disease or heart failure and
    • Take eight or more maintenance prescriptions for Part D drugs each month, and
    • Spend at least $4,935 on Part D prescription drugs each year.

While this program isn't a benefit, it's included in all our Medicare plans that include prescription drug coverage. Your enrollment is free, voluntary, and doesn’t affect your drug coverage under Medicare.

How does it work?

Once you're in the program, we'll keep track of the prescriptions you're taking in two ways.

  • At least four times a year, our team of pharmacists will review the list of prescriptions you're taking. We call this a Targeted Medication Review. We may reach out to you or your doctor if we see any potential problems.
  • At least once a year, we'll offer to talk to you about how to use your prescriptions safely. We call this a Comprehensive Medication Review. The conversation can happen over the phone and takes about 30 minutes. After the call, we'll send you a plan to help you get the best results from your prescriptions. We call it a Recommended To-Do List.

We'll also send you a list of the medications you're taking to help you keep track of them. It's called a Personal Medication List.

You can find a blank copy of the Personal Medication List in our forms section.

How do I sign up?

If you qualify for Medication Therapy Management, we’ll send you a letter letting you know you’re enrolled. The letter will also have more information about the program.

If you have any other questions about this program or want to know if you qualify, call the number on the back of your member ID card.