Get Help Navigating Your Prescription Drug Benefits

Get Help Navigating Your Prescription Drug Benefits

Get Help Navigating Your Prescription Drug Benefits

Pharmaceutical Care Management (PCM) is available to members who have Prime Therapeutics (Prime) pharmacy administration. Check Blue Access for MembersSM or ask your benefits administrator to see if you have Prime and the PCM benefit.

Prescription drugs can be confusing. There’s a lot to consider — how and when to take them, with or without food, possible interactions with other medicines you’re already taking.

And then there are the differences between generics and brand name drugs, understanding what your plan covers and how to keep your costs down. Wouldn’t it be nice to have a helping hand to help answer your pharmacy questions?

If you have Prime Therapeutics (Prime) as your pharmacy administrator, you have access to Pharmaceutical Care Management (PCM), a service that does just that. PCM is a team of pharmacists and pharmacy technicians that work with nurses, doctors and care advocates to provide you with well-rounded care. This involves answering any questions you may have about your prescription drugs, making sure they are being taken as prescribed and finding ways you may be able to save on out-of-pocket costs.

How Does It Work and How Can It Benefit Me?

Get Answers
The PCM program gives members easy access to tips and support when they have pharmacy and drug-related questions. If your plan has the PCM program, you can ask for a pharmacist when you call the customer service number on your Member ID card. The pharmacist can help answer your questions.

Medication Review
If you take multiple medicines and need some help managing them, you may be able to request a medication review by calling the customer service number on your member ID card. And in some cases, we may reach out to members and suggest they participate in a review. Participation is voluntary, and this review is provided at no extra cost to you.

During a review, a clinical pharmacist from our dedicated team will talk to you about the medicines you are taking and help make sure your treatment is safe and works well. The first call may start with a full review of your medicines. A member of the PCM team will ask you some questions about the medicines you are taking. This review is done to help lower your chance of a drug-related problem, such as harmful drug interactions or adherence issues.

The PCM team can also share ways to help lower your out-of-pocket costs and answer any of your medication questions.

Here are some of the topics that may be discussed during a PCM review:

  • Allergic reactions
  • Managing drug side effects
  • Drug interactions
  • Using too much or not enough medicine
  • Taking more than one drug to treat the same problem
  • Untreated medical conditions
  • Not refilling prescription drugs on a regular schedule
  • Missing dosages or not taking as prescribed
  • Support for infusion and IV therapy
  • Pain management
  • Cost-savings options

Treatment decisions are always between you and your doctor. Always talk to your doctor about any medication questions you have.

Coverage is based on the terms and limits of your benefit plan. Not all plans may have the PCM program review. See your plan materials for details. If you have questions about your benefits, call the customer service number on your member ID card.

Prime Therapeutics, LLC, is a separate pharmacy benefit management company contracted by Blue Cross and Blue Shield of New Mexico (BCBSNM) to provide pharmacy benefit management and other related services. In addition, contracting pharmacies are contracted through Prime Therapeutics. The relationship between BCBSNM and contracting pharmacies is that of independent contractors. BCBSNM, as well as several independent Blue Cross and Blue Shield Plans, has an ownership interest in Prime Therapeutics. 

MyPrime.com is an online resource offered by Prime Therapeutics, LLC.
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