The Bright HealthCare Medication Therapy Management (MTM) program.
Basics of the MTM program.
The Bright HealthCare Medication Therapy Management program helps you get the greatest health benefit from your medications by:
- Preventing or reducing drug-related risks
- Increasing your awareness
- Supporting good habits
Who qualifies for the program?
We will automatically enroll you in the Bright HealthCare program at no cost to you if all three conditions apply:
- You take eight or more Medicare Part D covered maintenance drugs, and
- You have three or more of these long-term health conditions:
- Chronic obstructive pulmonary disease
- • Cardiovascular disorders such as high blood pressure and high cholesterol or coronary artery disease, and
- You reach $4,376 in yearly prescription drug costs paid by you and the plan.
Your participation is voluntary and does not affect your coverage. This program is no cost to you and is open only to those who are invited to participate. The program is not a benefit for all members.
What services are included in the program?
The program provides you with a:
- Comprehensive medication review, and
- Targeted medication review
Comprehensive Medication Review
- 30-minute visit between an MTM Pharmacist
- A Pharmacist will perform a review of all member medications (including prescription, over-the-counter(OTC) medications, herbal therapies, and dietary supplements) and medical conditions to determine if there are any drug therapy issues
- If needed, the Pharmacist will work with the member’s provider to resolve any issues identified as part of the review
- Within 14 days following the Comprehensive Medication Review, the Pharmacist will mail the member a Personal Medication List, which summarizes their medication history, and a Medication Action Plan, which summarizes any clinical concerns that were identified. Information may also be mailed to the member’s provider, based upon opportunities for medication therapy improvement.
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 provider. The review takes about 30 minutes and is usually offered once each year — if you qualify. At the end of your discussion, the Pharmacist will provide you a Personal Medication List with the medications you discussed during your review.
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 an example of the Personal Medication List that you’ll walk through as a part of the program.
Targeted Medication Review
In addition, once every three months Bright HealthCare will perform a “Targeted Review” of the member’s medications. After each review, Bright HealthCare may contact the member’s provider with suggestions about medications that may be safer or a better alternative to the current therapy. As always, medications won’t change unless the member and their provider decide to change them.
How will I know if I qualify for the program?
If you qualify, we will mail you a letter. Also, you may receive a call, inviting you to participate in this one-on-one medication review.
Who will contact me about the review?
You may be contacted by a Pharmacist to provide your review and ensure that you have access to the service if you want to participate. These reviews are conducted by phone.
Why is a review with a pharmacist important?
Different providers may write prescriptions for you without knowing all the prescription drugs and/or OTC medications you take. For that reason, a Pharmacist will:
- Discuss how your prescription drugs and OTC medications may affect each other
- Identify any prescription drugs and OTC medications that may cause side effects and offer suggestions to help
- Help you get the most benefit from all of your prescription drugs and OTC medications
- Review opportunities to help you reduce your prescription drug costs
How do I benefit from talking with a pharmacist?
- Discussing your medications can result in real peace of mind knowing that you are taking your prescription drugs and OTC medications safely
- The pharmacy can look for ways to help you save money on your out-of-pocket prescription drug costs
- You benefit by having a Personal Medication List and a Medication Action Plan to keep and share with your doctors and health care providers
How can I get more information about the program?
Please contact us if you would like additional information about our program, or if you do not want to participate after being enrolled in the program. Our number is 1-866-342-2183 9-5 EST Mon-Fri. (TTY users, call 711.)
By entering my phone number and/or email address, I agree that Bright HealthCare and/or a sales agent may call or email me, provide me with information about the plan, and answer any questions I may have.
Website Last Updated: Jan 13 2021