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Drug
Management Programs to help members use drugs safely
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FamilyCare has several ways to help our members with safe and
appropriate medication use.
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Drug
Formulary
The formulary is created by a team of practicing doctors and
pharmacists who carefully evaluate the available scientific evidence.
For some prescription drugs, the team has recommended additional
requirements for coverage or limits on our coverage. These requirements
and limits ensure that our members use these drugs safely and
effectively.
Drug
Utilization Reviews
Drug
Utilization Reviews help prevent medication problems such as
over-medication or drug interactions, When you fill a prescription at
the pharmacy, the pharmacist submits the prescription to us
electronically for payment.
Our computer system automatically compares this prescription to other
prescriptions you have filled, including prescriptions at other
pharmacies. If it detects a potential problem, it alerts the pharmacist
so he or she can discuss the issue with you and/or your doctor.
Potential problems include (but are not limited to):
- Possible
medication errors in dose or quantity
- Duplicate drugs
that may be unnecessary because you are taking another drug to
treat the same medical condition
- Drugs that may
not be safe or appropriate because of your age, gender or disease
- Certain
combinations of drugs that could harm you if taken at the same
time
- Prescriptions
written for drugs that have ingredients you are allergic to
Medication
Therapy Management Program (MTM)
This
program is especially helpful for members who take several medications
for chronic medical conditions, such as hypertension, hyperlipidemia,
diabetes, and asthma.
- A FamilyCare
pharmacist may contact you to talk about all of the medications
you are taking, including over-the-counter medications or natural
supplements. They will make sure you understand what they are for
and how to take them safely. The pharmacist will also work with
your providers to make sure you are taking the safest and most
effective medications.
- There is no cost
for this program and if you qualify for this program we will
contact you. We hope you will participate so that we can make sure
that you are using the drugs that work best to treat your medical
conditions and help us identify possible medication errors.
- If you have
questions about the Medicare Medication Therapy Management
Program, please call Member Services at (866) 798-2273, TTY/TDD
users should call (800) 735-2900.
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