If you're concerned about medication safety, Blue Cross Blue Shield of Michigan has programs that protect you and your budget.
We work with an expert team of doctors and pharmacists who are looking out for you. They help us develop programs we use to:
Utilization management is monitoring the use of certain prescription drugs. We do this by adding requirements for your plan to cover certain prescription drugs. Or there may be limits on how many times you can fill a prescription. These programs include:
You can find out if the drug you take has any of these restrictions by looking in your plan's drug list, also called a formulary. You can also call the number on the back of your member ID card.
If you need to request an exception, you or your doctor can submit a coverage determination request.
Every time you fill a prescription, we review your records to make sure your prescriptions are safe and appropriate. We do this for all our members on a regular basis.
These reviews are especially important if more than one doctor prescribes medications for you. We look for problems like:
If we see a problem, we'll work with your doctor to correct it.
Not taking your medication as suggested can negatively impact your treatment and health.
Our Medicare pharmacy team reviews your prescription history and makes outreach phone calls to help: