Medication Therapy Management Program
The Medication Therapy Management (MTM) program reviews the medicines you take to make sure that they are safe, work well and fit your lifestyle. This program is offered at no additional cost to eligible members and is not considered a separate benefit.
The goal of MTM is to help you get the best results from your medicines, at the lowest possible price. The MTM program can help you:
- Learn how to get the most from your medicines
- Lower your risk for potentially harmful drug reactions and side effects
- Learn why it is important to take your medicines on time
The program can also help you and your doctor make sure that your medicines are the best choice for you.
Who is eligible for MTM?
If we have a MTM program that fits your needs, we will automatically enroll you and send you information.
You are automatically enrolled if you meet the following criteria:
- Have three or more of the following conditions:
- Asthma
- Cardiovascular Disease
- Chronic Heart Failure
- Diabetes
- Mental Health Disorders, including depression
- Osteoporosis
- Chronic Obstructive Pulmonary Disease (COPD)
- Take eight or more prescription medicines covered by Medicare Part D AND
- Expect to spend more than $4,696 annually or at least $1,174 quarterly on prescription medicines covered by Medicare Part D.
How will I know if I'm selected?
We will mail you a letter if you qualify.
A MTM program pharmacist will schedule a one-on-one medication review with you.
The pharmacist offers ways to manage your conditions with the drugs you take. The pharmacist may contact your prescribing doctor. A Comprehensive Medication Review (CMR) takes about 30 minutes and is usually offered once each year if you qualify. At the end of your discussion, the pharmacist will give you a personal medication list of the medications you discussed during your review.
We will mail or fax a Targeted Medication Review (TMR) to your doctor every three months. The TMR includes suggestions regarding prescription drugs that may be safer or more efficient than the drugs you currently take. Your prescription drugs will not change unless you and your doctor decide to make a change.
Opting out
Medicare requires us to automatically enroll you if you are eligible. But, this service is voluntary — you are not required to participate. You may also choose to take part in only certain services you find valuable. You can cancel your enrollment at any time during the calendar year. Your prescription drug coverage will not change whether you take part in the MTM program or not.
How can I get more information about the MTM Program?
Call Member Services at 844.866.3735 (TTY:711), 24 hours a day, 7 days a week.
