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Medication Therapy Management

A Medication Therapy Management (MTM) program is offered to our members who are enrolled in our Medicare Part D prescription drug plans. MTM is a free, voluntary program that is offered to our Members, with limited eligibility requirements, to assist with controlling a long-term health condition. The MTM program is not a plan benefit. It is an educational program offered to members.

Who can participate in the MTM program?

Members who meet all three of the following criteria are eligible:

  • Members who have at least three of the following chronic diseases:
    • Asthma
    • Cardiovascular Disease
    • Chronic Heart Failure
    • Diabetes
    • Mental Health Disorders, including depression
    • Osteoporosis
    • Chronic Obstructive Pulmonary Disease (COPD)
  • Members who are taking at least eight chronic/maintenance Part D covered drugs per month.
  • Members who have incurred costs for Part D covered drugs of at least $4,696 annually or at least $1,174 quarterly.

What does the MTM Program do?

The MTM Program is designed to:

  • Provide helpful information about the medications you take to manage your chronic diseases
  • Reduce your risk of drug reactions and harmful side effects
  • Help you use your medications as effectively as possible

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.

How can I get more information about the MTM Program?

Call Customer Service at 844.866.3735 (TTY: 711), 24 hours a day, seven days a week.

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Updated October 1, 2022