About Blue Medicare Advantage

Blue Medicare Advantage (Blue MA) is the trade name of Group Retiree Health Solutions, Inc. an independent licensee of the Blue Cross and Blue Shield Association, and was created within the joint venture of Independence Blue Cross (Independence) and Anthem, Inc. (Anthem). Blue MA leverages the group Medicare Advantage and Prescription strengths of both the Independence and Anthem organizations.
There may be times when we use other companies to give our members and providers certain types of services, like Utilization Management or Case Management. We would always make sure that it was approved by law and allowed by our contracts beforehand.

Medical Policies

We do our best to keep our coverage and benefits consistent with all current clinical and behavioral health guidelines. Sometimes our decisions are based on federal or state law.

Medication Therapy Management Program

The Medication Therapy Management (MTM) program helps you and your doctor make sure that your medications are working to improve your health.
The Medication Therapy Management (MTM) program is a free service for eligible members with multiple health conditions taking multiple medications. The MTM program helps you and your doctor make sure that your medications are working to improve your health.
The MTM program is not considered a part of the plan’s benefit.
For information about the MTM program and how to obtain MTM program service documents or to see if you qualify, you can call the number on your member ID card.
To qualify for the MTM program, you must be eligible. If you qualify, you will be auto-enrolled in the program and the service is provided 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.
You may qualify for the MTM program for plans if you meet all of these requirements:
  • You have 3 or more chronic health problems. These may include:
    • Chronic Heart Failure (CHF)
    • Diabetes
    • High blood fat levels
    • High blood pressure
    • Rheumatoid Arthritis
  • You take 8 or more daily medicines covered by Medicare Part D.
  • You are spending $4376 or more in 2021 on Part D covered medications.
If you qualify for the MTM program, you will be contacted and have the chance to speak with a highly-trained pharmacist. During that call, the pharmacist will complete a comprehensive review of your medicines and talk with you about:
  • Any questions or concerns about your prescription or over-the-counter medicines, such as drug safety and cost.
  • Better understanding your medicines and how to take them.
  • How to get the most benefit from your medicine.
The MTM program helps you understand your medications and use them safely. If you qualify for the MTM program, you will receive:
  • A welcome letter that tells you how to get started.
  • A full medication review:
    • You will have the chance to review your medicines with a highly-trained pharmacist each year. This review will take about 20 to 30 minutes. During this call, any issues with your medicines will be discussed. The call can be scheduled at a time that works for you.
    • After you complete the full medication review, a summary is mailed to you. The summary includes a medication action plan with space for you to take notes or write down any follow-up questions. The action plan has steps you should take 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 of 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. You can also download a blank copy of the Personal Medication List using the link below.
  • Ongoing targeted medication reviews:
    • At least once every 3 months, your 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 a phone call for this review. 

Personal Medication List