The Medication Therapy Management Program (MTM) is intended to help eligible members with multiple conditions manage their drug therapy, and optimize medication use in order to improve therapeutic outcomes. This program enhances communication among physicians, healthcare professionals and members to ensure adequate and safe use of medications. Eligible members are automatically enrolled into the program but the member may choose not to participate. This program is not considered a benefit of the drug coverage, however it is offered at no additional cost to the member.
Members will automatically enter the program if they meet the following three criteria:
- Having incurred in expenses of Part D drug coverage, up to $1,011 in the last three months or $4,044.00 during the last 12 months.
- Having at least three chronic conditions as listed below:
1. Chronic Heart Failure (CHF)
3. Mental Health – Depression
4. Cardiovascular Disorders
5. Chronic Obstructive Pulmonary Disease (COPD)
7. Bone disease/Arthritis: Osteoporosis
- Being using at least eight chronic/maintenance drugs covered under Medicare Part D.
Services and Materials
Members enrolled in the MTM program receive:
- Welcome letter (through mail).
- Phone calls to beneficiary or caregiver for comprehensive medication review (CMR) offer.
- Annual interactive, person to person, comprehensive medication review (CMR) to identify potential drug therapy problems.
- Follow-up interventions by a qualified health professional, including quarterly targeted medications reviews.
- Consultations and interventions with prescribing physician to optimize drug therapy and resolve any medication related issues.
- Member will receive, within 14 days after the interview, a summary of the interview that will include the updated patient medication list and the action plan to be taken regarding the member’s drug therapy.
|Personal Medication List||Download|
For more information contact us at 1-844-212-9858 (Toll free), 1-833-523-2620 TTY, Monday through Friday from 8:00 a.m. to 8:00 p.m.