Medication Therapy Management

For EmblemHealth VIP Medicare Advantage Prescription Drug Plans:

To be eligible, you must meet the criteria of at least one of the following two groups (1) and/or (2).

1. 1. You take eight or more prescription medications for ongoing conditions covered by Medicare Part D
   2. You have at least three of the following conditions:
      1. Chronic Heart Failure (CHF)
      2. Diabetes
      3. Hypertension (high blood pressure)
      4. Dyslipidemia (high cholesterol)
      5. Osteoporosis
   3. You must be likely to spend $5,330 or more in 2024 on prescription medications covered by Medicare Part D
2. You are a good candidate for the Drug Management program based on the Centers for Medicare and Medicaid (CMS) guidelines.

For EmblemHealth Prescription Drug Plans for Group Retirees:

To be eligible, they must meet the criteria of at least one of the following two groups (1) and/or (2).

1. 1. You take eight or more prescription medications for ongoing conditions covered by Medicare Part D
   2. You have at least three of the following conditions:
      1. Asthma
      2. Chronic Obstructive Pulmonary Disease (COPD)
      3. Chronic Heart Failure (CHF)
      4. Diabetes
      5. Hypertension (high blood pressure)
      6. Dyslipidemia (high cholesterol)
      7. Depression
      8. End-Stage Renal Disease (ESRD)
      9. Osteoporosis
   3. You must be likely to spend $5,330 or more in 2024 on prescription medications covered by Medicare Part D
2. You are a good candidate for the Drug Management program based on the Centers for Medicare and Medicaid Services (CMS) guidelines.