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Medication Therapy Management (MTM)

What is the Medication Therapy Management Program?

The Medication Therapy Management Program (MTM) is aimed at improving your health and quality of life by ensuring safe and effective medication use and preventing medication-related issues.

The Triple-S Advantage (TSA) MTM Program is managed by a diverse group of healthcare professionals, composed of case managers, health educators, pharmacists and doctors. They will work in collaboration with you to obtain the maximum benefit from your medications, guaranteeing they are safe, appropriate and are working properly.

This Program is not part of your plan benefits package.

Who is eligible to participate in the MTM Program?

Beneficiaries who satisfy the following three (3) criteria are eligible to participate:

  • Have three (3) or more chronic diseases (such as osteoarthritis, rheumatoid arthritis, congestive heart failure, diabetes, dyslipidemia, asthma, COPD, and hypertension);
  • Use five (5) or more Medicare Part D drugs related to chronic conditions;
  • Utilize more than $4,376 in total Part D drug costs per year.

How much does the Program cost?

The MTM Program is offered at no additional cost to those beneficiaries who are eligible.

How does the MTM Program work?

With the goal of helping you learn more about your health condition, you will receive orientation and follow-up calls from our case managers and health educators.

In addition, a pharmacist will work with you, either in person or through telephone calls, to assess your medication therapy.

What services does the MTM Program provide?

  • Comprehensive review of your medications, including medications prescribed by your doctor and over-the-counter medications like vitamins and herbal supplements.
  • A list of your medications that will explain how to take them correctly and will help you monitor your treatment. You may print this list, fill in the information and take it with you when you visit your physician (view example).
  • Evaluate the risk of potential drug interactions.
  • Ensure you are not experiencing any side effects from your medications.
  • Recommend more cost effective medication alternatives.
  • Reach out to your healthcare provider when a potential medication related problem is identified.

How can I participate in the Program?

Once the eligible beneficiaries are identified by the TSA system, they are automatically enrolled in the program and will receive detailed information by mail.

If you have questions regarding our MTM Program or would like to receive additional information, please contact us at 1-855-831-3592, Monday through Friday from 8:00am to 5:00p.m. TTY users please call 1-855-296-8965.

Triple-S Advantage is an independent licensee of BlueCross BlueShield Association.

Last update: 15/10/2020

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