Medication Therapy Management Program

Blue Cross & Blue Shield of Rhode Island, in collaboration with Catamaran’s MedMonitor Medication Therapy Management (MTM) program, ensures you are receiving the most effective medications, while also helping to reduce the risk of side effects and interactions as well as your out-of-pocket costs. The program is paid in full by your plan. This means that you can receive the benefits of the MTM program at no cost to you. There is no change to insurance benefits, copays, prescription coverage, or available doctors or pharmacies. The MTM program is designed to help members who meet the below criteria to get the most from their medications:

  • Two or more chronic diseases including:
    • Chronic Heart Failure
    • Diabetes
    • Dyslipidemia
    • HIV/AIDs
    • Hypertension
    • Multiple Sclerosis
    • Respiratory Disease which includes Asthma or COPD
  • Four or more maintenance medications for chronic conditions , and
  • Likely to incur an annual drug spend of $3,144

Blue Cross & Blue Shield of Rhode Island’s members who meet the criteria will be sent an introduction letter which describes the MTM program. Specially trained pharmacists work closely with you and your doctors to solve any problems related to medicines and to help you get the best results. You will be contacted by a pharmacist for an interactive person-to-person consultation to review all of your medications and answer any questions that you may have.

Medicare requires that MTM programs automatically enroll those who qualify through the calendar year, but participation is voluntary, and members are given the opportunity to opt out at any time. Please note that the MTMP is not considered a benefit and based on the limited eligibility criteria, not all plan members will qualify.

You can take this personal medication list to your next doctor's appointment and complete it together with your doctor.

If you would like additional information or you do not wish to take part in the MTMP, please call Customer Service at the numbers on the Contact Us page. 

Blue Cross & Blue Shield of Rhode Island is an HMO plan with a Medicare contract. Enrollment in Blue Cross & Blue Shield of Rhode Island depends on contract renewal.

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