Medication Therapy Management (MTM) Program
The Medication Therapy Management (MTM) program reviews the medicines you take to make sure that they’re safe, work well and fit your lifestyle. This program is a service offered at no additional cost to eligible members. This service is not considered a benefit.
The goal 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 potential harmful drug reactions and side effects
- Learn why it’s 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’s eligible for MTM?
You are automatically enrolled if you meet the following criteria:
| 2020 |
|---|
1. Have three or more of the following conditions:
AND |
| 2. Take eight or more prescription medications covered by Medicare Part D.
AND |
| 3. Expect to spend more than $4,255 in 2020 on prescription medicines covered by Medicare Part D. |
What You Can Expect
The MTM program is a two-part program. Reviews can be done over the phone, whenever it’s convenient for you. In some cases, you may have an in-person review.
Comprehensive Medication Review (CMR)
This personalized review lets you talk one-on-one with a pharmacist. To get ready for your review make a list of all the medicines you take. Include how much you take each day and how often you take them. Be sure to include over-the-counter medicines or supplements. The pharmacist will review your list and talk about it with you. This usually takes about 30 minutes. After your review, you’ll get a complete list of your medicines a personal medication list and an action plan that you can bring with you to your next doctor’s visit.
Targeted Medication Review (TMR)
Every few months, the program reviews your prescription claims to make sure there are no issues that need attention. If the review identifies any issues, we may contact your doctor.
Getting Started
If you’re eligible for MTM, you’re automatically enrolled. You’ll get a letter or a phone call letting you know how to schedule an appointment or opt out of the program.
Opting out
Medicare requires us to automatically enroll you if you’re eligible. But, this service is voluntary — you’re not required to participate. You may also choose to take part in only certain services you find valuable. You can cancel your enrollment or choose to reenroll at any time during the calendar year. Your prescription drug coverage will not change if you take part in the MTM program or not.
The MTM Program is a service offered to eligible members at no additional cost; this service is not considered a benefit.
Our purpose is to help you get the medicine you need to feel better and live well.
Additional information about Medication Therapy Management
For additional information, please call our Customer Service number at 1-877-774-8592 (TTY/TDD users should call 711). We are open between 8:00 a.m. – 8:00 p.m., local time, 7 days a week. If you are calling from April 1 through September 30, alternate technologies (for example, voicemail) will be used on the weekends and holidays.
