Medication Therapy Management Program (MTMP)

The Medication Therapy Management Program (MTMP) is a free service for eligible members who may have multiple health conditions and who may be taking multiple medicines. The MTMP was designed by doctors and pharmacists to help you get the best results from all the medications you are taking. The MTMP will help you and your doctor make sure that your medicines are working to improve your health. To qualify for the MTMP, you must be eligible. Eligibility details can be found below. If you qualify, you will be auto enrolled into the program at no additional cost to you. You may choose not to participate in the program, but it is recommended that you make use of this free service. The MTMP is not considered a part of the plan’s benefit.

For information about the MTMP and how to obtain MTM service documents or to see if you qualify, you can call the number on your member ID card.

Members who use their plan’s website or mobile app could also log in and, if qualified, schedule a comprehensive medication review (CMR) at a time convenient for them.

Blue Cross of Idaho Care Plus, Inc. wants you to have every opportunity to participate in this program when and where convenient for you. That is why we also work with other health organizations to provide MTMP services on our behalf. One of these organizations may contact you about completing a Comprehensive Medication Review (CMR) or other MTMP services.

Partner organizations: Clinical Pharmacy Care Center – CarelonRx and MedWatchers*.

*Additional partner organizations may be added if they meet our rigorous requirements to service our members.

You may quailify for the MTMP if:

In 2025

• You have 3 or more chronic health problems. These may include:
  • Alzheimer's Disease (AD)
  • Chronic Heart Failure (CHF)
  • Diabetes
  • End Stage Renal Disease (ESRD)
  • High blood fat levels/Dyslipidemia (High Cholesterol)
  • Human Immunodeficiency Virus / Acquired Immunodeficiency Syndrome (HIV/AIDS)
  • Hypertension
  • Mental Health (Depression, Schizophrenia, Bipolar Disorder, or Other Mental Health Conditions)
  • Respiratory Disease (Asthma, Chronic Obstructive Pulmonary Disease (COPD), or Other Chronic Pulmonary Disorders)
  • Bone Disease (Rheumatoid Arthritis (RA), Osteoporosis, and Osteoarthristis)
• You take 8 or more maintenance medicines in the Medicare Part D drug classes.
• You are spending $1,623 or more in 2025 on Part D covered medications.
• Additionally, members that are enrolled in their Health Plan's Drug Management Program(s) may be auto enrolled in the MTMP.

If you qualify for the MTMP, you will be contacted and have the chance to speak one-on-one with a highly trained pharmacist. Together, you and the pharmacist will complete a comprehensive medication review (CMR) and can talk about:

• Any questions or concerns you have about your prescription or over-the-counter medicines, such as drug safety and cost.
• How your medicines work and how best to take them safely and conveniently.

If you qualify for the MTMP, you will receive:

• A welcome letter and/or phone call that tells you how to get started.
• A comprehensive medication review or CMR.
  • The CMR typically takes about 10 to 20 minutes and will vary depending on your needs.
  • The CMR can be scheduled at a time that works best for you.
  • After you complete the CMR, a summary is mailed to you. The summary includes a medication action plan reviewing what you and the pharmacist discussed, with additional space for you to take notes or write down any follow-up questions. The action plan has steps you should take, including sharing with your doctor(s), to help you get the best results from your medications.
  • You also will be mailed a personal medication list. It's a list of all the medicines that you take and the reasons why you take them. The medication list will help you keep track of your medications and how to use them the right way.
    • Personal medication list
    • Lista de Medicamentos
• Ongoing targeted medication reviews
  • At least once every 3 months, our medicines will be reviewed, and you or your doctor will be contacted if there are recommendations for any changes in your medicines.
  • You may get a letter or phone call for this review.