At ADVANTAGE Health Solutions, our goal is to make sure our members have the types of programs available that will help them improve their outcomes. We offer services that go beyond traditional Medicare coverage.

Our Care-ADVANTAGE^® programs help members get the services they may need which helps to reduce many of their worries. Our care team is available to address health concerns. We give education about medical conditions or medicines and assist members in talking with their doctors. We are here to help our members take charge of their care and navigate the health care system. Our services are voluntary and are at no additional cost to members.

Health Coaching

Our health coaches include nurses, nurse practitioners, social workers, pharmacists and health educators. We reach our members by telephone or, if needed, we will visit our members in their home. We focus on health concerns that usually cause older adults to have a harder time with managing their care, such as:

Once we find a concern, we work with members and their doctors to help find a solution. For information about our Health Coach services please call our ADVANTAGE Member Services at 1-800-523-7533; Monday through Friday from 8 a.m. to 8 p.m. TTY/TDD users should call 1-800-743-3333.

Transitional Care Coordination

We offer services to assist with changes in health. Our goal is to help our members who become sick return to being active. We give support to members following a stay in the hospital or skilled nursing facility. We give members a chance to discuss their concerns when returning home from the hospital. Our nurses visit many of our transitioning members during their stay in a facility.

After a hospital stay, our nurses:

Case Management

Several members have ongoing concerns with coordinating care and arranging services. Our Case Managers reach out to those members with complex medical and care needs. Together the member, Case Manager and doctors identify ways for achieving better health outcomes for the member.

For more information about Case Management services, members and providers can call our ADVANTAGE Member Services at 1-800-523-7533; Monday through Friday from 8 a.m. to 8 p.m. TTY/TDD users should call 1-800-743-3333.

Medication Therapy Management

Medication Therapy Management Program, MTMP for short, is a program that focuses on the medications our members are taking. Members work with our pharmacists and nurses to get the most benefit from their prescription drugs or medicines.

Please note that MTMP is not a part of your benefit, but is instead an added service available and provided at no additional cost to our members.

Who can participate in MTMP?

Members who have three (3) or more of the following chronic conditions can be selected for MTMP:

• Bone Disease – Arthritis – Osteoporosis
• Diabetes Mellitus
• Dyslipidemia
• Hypertension

Members who are taking more than 8 medications and have higher cost medicines can also become part of the MTMP.

Can I enroll in the MTMP program?

Members are identified by prescription records. Members are enrolled in the MTMP, if they meet the program criteria. Members are identified every three months.

Do I have to participate in the MTMP program?

No. Participation is voluntary. Members who meet the MTMP criteria have the right to let us know whether or not you want to participate.

What will MTMP consist of?

MTMP looks closely at the medications used by members. We check for possible interactions between different medications. Our pharmacists and nurses reach members by telephone or mail written information. We help members get the most from their prescription medications.

How do I get more information or ask other questions about MTMP?

To learn more about MTMP or prescription drug coverage, please contact ADVANTAGE Member Services at 1-800-523-7533, Monday through Friday from 8 a.m. to 8 p.m. TTY/TDD users should call 1-800-743-3333.

Disease Management

Care-ADVANTAGE^® offers Disease Management programs for members who are dealing with long-term conditions. Members work with our Health Educators to set personal goals and learn ways to manage their chronic conditions.

Our Disease Management programs include the following conditions:

For more information about our Disease Management programs, call us at 1-877-901-2237 ext 2922, Monday through Friday 8 a.m. to 5 p.m. and speak to our Disease Management Coordinator.

Our Care Management Support Services are made available to all members of ADVANTAGE Health Solutions. If you have questions about programs or other services, please feel free to contact Member Services at 1-800-523-7533, Monday through Friday from 8 a.m. to 8 p.m. TTY/TDD users should call 1-800-743-3333.

The benefit information provided herein is a brief summary, but not a comprehensive description of available benefits. Additional information about benefits is available to assist you in making a decision about your coverage. This is an advertisement: for more information contact the plan.