Prescription Support Programs

We know that taking your prescription drugs as your doctor orders can mean better health outcomes for you. That’s why we offer you support to help you stay on track and stay healthy.

Medication Refill Reminders

We may call to check on you when certain medications are refilled late or if you have been late refilling medications in the past.

You can also speak with a pharmacist who can help you overcome any barriers keeping you from getting and taking your medicine. The pharmacist can offer helpful tips, provide you with reminder tools or help transfer your prescriptions to mail order.

Medication Therapy Management (MTM) Program

The Medication Therapy Management (MTM) Program is a service for members with multiple health conditions who also take multiple medicines. The MTM program helps you and your doctor make sure that your medicines are working to improve your health.

Blue Advantage determines eligibility monthly by looking at your pharmacy and medical claims. Once you qualify, you are automatically enrolled in the program for the rest of the calendar year.

To qualify for the 2024 MTM program, you must meet all three of the following criteria:

  • You have three of the following conditions:
    • Congestive heart failure, diabetes, high cholesterol, high blood pressure, COPD, anemia, chronic noncancer pain,
  • You are taking eight or more chronic/maintenance (covered Part D) classes of medications, AND
  • You are likely to spend more than $5,330 in 2024 on prescription drug costs (includes amounts paid by both you and Blue Advantage) OR
  • You are enrolled in a Drug Management Program that helps you better manage and safely use your medications such as those used for pain

If you qualify, you will receive a letter with information on scheduling a 20 – 30-minute phone call for a detailed medication review. During that call, a pharmacist or pharmacy intern will complete a comprehensive medication 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 medicines

A summary will be mailed to you that includes a medication action plan with space for you to take notes or write down any follow-up questions. You will also receive a personal medication list of all the medicines you take and why you take them.

At least once every 3 months, your medications will be reviewed, and you or your doctor will be contacted about any possible changes in your medicines.

Now that you know how to get your prescription drugs more conveniently, you’re on the right path to maintaining and improving your health. Learn more by clicking on the tiles below!

View the Formulary & Utilization Management

View the formulary to know which drugs are covered by the plan and which may require utilization management, such as prior authorizations.

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Getting Your Prescription Drugs

As a Blue Advantage member, you can use these money and time-saving tools – like a three-month supply – to make getting your prescriptions even easier!

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Special note: Some Blue Advantage (HMO) – Group Medicare Advantage plans do not offer preferred cost-sharing when you use a preferred pharmacy. You can still use a preferred pharmacy but may not pay less for your prescriptions than you would at a standard network pharmacy. If you are a Blue Advantage (HMO) – Group Medicare Advantage member, read your plan’s Benefit Documents to see if this applies to you.

Express Scripts is an independent company that serves as the pharmacy benefit manager for Blue Cross and Blue Shield of Louisiana and Blue Cross and Blue Shield of Louisiana HMO.

We're always happy to help!

Just a Phone Call Away

Reach out to us for help or any questions you may have about your health care coverage and plan benefits.

Call us at: 1-866-508-7145 (TTY 711). Our phone lines are open 8 a.m. to 8 p.m., 7 days a week from October - March and 8 a.m. to 8 p.m., Monday - Friday from April - September

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