Medication Therapy Management Program
Medication Therapy Management Program (MTM) is a free program for qualifying members. This program helps you and your doctor be sure your medications are working to improve your health.
Are you eligible for the Medication Therapy Management Program?
Beneficiaries are eligible for the MTM program if they meet ALL of the following criteria:
- Have at least three of the following chronic disease states:
- Alzheimer’s disease
- Rheumatoid arthritis
- End-stage renal disease
- Chronic obstructive pulmonary disease (COPD)
- Chronic alcohol and other drug dependence
- Are taking at least 8 covered Medicare Part D drugs
- Are likely to incur annual Medicare Part D costs greater than or equal to $3,017
What services do participants receive with the Medication Therapy Management Program?
Each MTM eligible member may receive the following FREE services:
- Interactive, person-to-person comprehensive medication review (CMR) with a qualified MTM provider, which is designed to improve patients’ knowledge of their prescriptions, over the counter (OTC) medications, herbal therapies and dietary supplements. The comprehensive medication review also helps identify and address problems or concerns that the patient may have, and empowers patients to self manage their medications and their health conditions.
- Quarterly screenings for actual or potential medication-related problems with notifications sent to the primary care team.
How will participants be notified that they are eligible and enrolled in the Medication Therapy Management Program?
- A Centers for Medicare & Medicaid Services (CMS)-approved letter is mailed to beneficiaries within 60 days of program enrollment offering them a comprehensive medication review.
- Members may also be contacted via telephone to schedule their comprehensive medication review.
- The comprehensive medication review will take place in person, via telephone, or other means. It is a discussion between the member or authorized representative and the qualified MTM provider. The review usually takes 30 to 60 minutes.
- After the comprehensive medication review, beneficiaries will receive an individualized written summary in the CMS standardized format. This includes a cover letter, medication action plan and personal medication list. Download a blank copy of the Personalized Medication List (pdf).
- Targeted medication reviews are performed with your primary care team to notify them of actual or potential medication-related problems.
For more information, please call our Member Services team at 1-866-610-2273 (TTY 711). We are available 24 hours a day, 7 days a week.
“Medication Therapy Mamangement Programs are not considered a benefit.”
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Last Updated 12/20/2013