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Personal Pharmacist Program
 Medication Therapy Management
This program is available to certain qualified CareAdvantage members to help them get the best results from their medications. The pharmacists who provide this service are trained by Outcomes Pharmaceutical Health Care. This program is free to members.
What are the requirements to qualify? There are three requirements.
| 1. |
Members must be diagnosed with at least two of the following medical conditions:
 | Diabetes |
| | Asthma |
| | Parkinson’s Disease |
| | Congestive Heart Failure |
| | Coronary Artery Disease |
| | Chronic Renal Failure |
| | Hypertension |
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| | Hyperlipidemia |
| | HIV/AIDS/Chronic Viral Disease |
| | Chronic Pain |
| | Multiple Sclerosis |
| | Cancer |
| | Chronic Obstructive Pulmonary Disease |
| | Hepatitis C |
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| 2. |
Members must be taking three or more drugs that are covered by the Part D prescription drug benefit.
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| 3. |
Members must be identified by the Health Plan of San Mateo (HPSM) as likely to need covered Medicare Part D drugs that will cost at least $4,000 in one year. HPSM will choose members whose Medicare covered part D drugs equal $1,000 or more during a three-month period. |
What are the services that the Outcomes Personal Pharmacist Program offers?
Medication Check-up:
You may take all your medications and over-the-counter products to an Outcomes Personal Pharmacist, and he/she will check each one with you. This will help identify any duplicates or conflicts and help you organize your medications.
Prescription Drug Patient Education:
Outcomes Personal Pharmacists will give you the extra attention you need to make sure your medications are working for you. When starting a new medication, an Outcomes Personal Pharmacist will:
| | Tell you about what it does and how to take it.
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| | Make sure the medication is working right and you are not having any problems. |
Prescriber Consultation:
An Outcomes Personal Pharmacist will work with you and your doctor(s) to take care of your medication needs. This includes prescription and non-prescription drugs.
Questions you may have:
Why do I need an Outcomes Personal Pharmacist?
An Outcomes Personal Pharmacist will help you understand the medications you take and tell you if they are right for you, or if you are taking them correctly. This can help improve your health and lower you risk of having a serious reaction to your medications. This could avoid a visit to the emergency room.
Are all pharmacists in the CareAdvantage pharmacy network also Outcomes Personal Pharmacists?
No. Not all pharmacists in the CareAdvantage pharmacy network are Outcomes Personal Pharmacists. Outcomes Personal Pharmacists have been trained to provide these extra services. The training course is open to any pharmacist. Ask your regular pharmacist if he or she participates.
Can I go to my regular pharmacy and still visit an Outcomes Personal Pharmacist too?
Yes. Your Outcomes Personal Pharmacist is a benefit of CareAdvantage membership. You can continue to go to any CareAdvantage participating pharmacy to get your medications.
Will I have to pay to see an Outcomes Personal Pharmacist?
No. Outcomes Personal Pharmacist services are free.
Will my doctor know if any changes need to be made to my prescriptions?
Yes. Your Outcomes Personal Pharmacist may make recommendations to you and your doctor(s). Only your doctor can change your prescription.
Will I be required to use an Outcomes Personal Pharmacist?
No. Outcomes Personal Pharmacists are an added benefit of your membership. They are there to help, but you do not have to use them.
How do I get started?
If you think you qualify call our CareAdvantage Unit to let us know you want to sign up. Our call center hours are Monday through Sunday, 8:00 a.m. to 8:00 p.m.
Can I change my mind about signing-up?
Yes. If you sign-up and you do not like the program, you can call a CareAdvantage Navigator to get out of it at any time. You will stay eligible for this program for the rest of the calendar year.
For more information about the Personal Pharmacist Program, call our CareAdvantage Unit 1-866- 880-0606 or (650) 616 -2174 TTY 1(800)735-2929
Call center hours: 8 a.m. to 8 p.m., Monday through Sunday
Office hours: Monday through Friday, 8 a.m. to 5 p.m.
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