Medication Therapy Management

IEHP DualChoice Cal MediConnect Plan (Medicare-Medicaid Plan) has partnered with PerformRx to offer medication therapy management programs at no additional cost for members who have multiple medical conditions, who are taking many prescription drugs, and who have high drug costs. A team of pharmacists and doctors developed these medication therapy programs to help us provide better prescription drug coverage for plan members. For example, these programs help us make sure that our members are using appropriate drugs to treat their medical conditions and help IEHP DualChoice identify possible medication errors.

IEHP DualChoice offers medication therapy management programs for members who meet specific criteria. As an IEHP DualChoice member we may notify you of enrollment into the program. IEHP hopes that you will participate in the program offered to help you manage your medications. Remember, you do not need to pay anything extra to participate. If you are selected as an eligible participant for a medication therapy management program, IEHP DualChoice will send you information about the specific program, including information on how to disenroll should you choose not to participate in the program. If you decide not to participate, your enrollment and eligibility in IEHP DualChoice will not be affected.

These programs may have limited eligibility criteria and are not considered a benefit. They are available for the following conditions:

1.  Have a minimum of 3 disease states:

  • Bone Disease-Arthritis-Osteoporosis
  • Diabetes mellitus
  • Respiratory Disease-COPD
  • Dyslipidemia
  • Chronic Heart Failure
  • Hypertension
  • Respiratory Disease - Asthma
  • Bone Disease-Arthritis-Rheumatoid Arthritis
  • End Stage Renal disease requiring dialysis
  • Mental Health- Chronic/Disabling Mental Health Conditions

2.  Be on a minimum of 5 different medications to treat those disease states:

  • ACE-Inhibitors
  • Antidepressants
  • Antipsychotics
  • Inhaled Corticosteroids
  • Selective Serotonin Reuptake Inhibitors (SSRIs)
  • Insulins
  • Beta-blockers
  • Antihyperlipidemics
  • Bronchodilators
  • Antihypertensives
  • Angiotensin II receptor blockers (ARBs)
  • Oral hypoglycemics
  • Calcium channel blockers
  • Bisphoshonates
  • Diuretics
  • Vitamin D Analogs
  • Colony Stimulating Factors
  • Disease Modifying Anti-Rheumatic Drugs (DMARDS)
  • Phosphate Binders
  • Glucocorticosteroids
  • NSAIDs

3.  Drug costs one-fourth of $3,919 ($979.75) for the previous three months are likely to be incurred.

If we contact you, we hope you will join so we can help you manage your medications. Remember, you don’t need to pay anything extra to participate.

For more information, contact IEHP DualChoice Member Services at 1-877-273-IEHP (4347), 8am - 8pm (PST), 7 days a week including holidays. TDD/TTY users, please call 1-800-718-4347.

IEHP DualChoice Cal MediConnect Plan (Medicare-Medicaid Plan) is a Health Plan that contracts with both Medicare and Medi-Cal to provide benefits of both programs to enrollees.

Information on this page is current as of October 15, 2018.
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