Medication Therapy Management Program

If you have complex health needs, you may be eligible to participate in our Medication Therapy Management (MTM) program, designed to help you and your doctor make sure that your medications are working. Our MTM program is provided at no additional cost to you.

Our MTM program includes a free discussion and review of all of your medications by a pharmacist or other health professional to help you use them safely. You will get a summary of this discussion to help you get the most benefit from your medications. You can have this summary available when you talk with your doctors or other health care providers.

Our MTM Program targets members who meet the following criteria:

  1. Members who meet the following three criterion:
    • Fill at least 8 different Medicare Part D medications, and  
    • Have at least three out of the following five disease states: Alzheimer’s disease, bone disease (osteoporosis), chronic heart failure, diabetes, respiratory disease (chronic obstructive pulmonary disease (COPD)), and
    • Members who estimate spending about $5,330 on medications over the course of the year. 
  2. Members with an active coverage limitation under a Drug Management Program.

Download our brochure to learn more about the Medication Therapy Management program, program criteria and eligibility requirements below.

View 2024 PDF

View 2023 PDF

Program Features

Our MTM Program offers you the following:

  • Enhances the member’s understanding through education and interventions that promote the appropriate use of the  medications, and reduces the risk of potentially adverse events associated with the use of the medication
  • Increases member adherence to prescription medication regimens by providing refill reminders, compliance programs
  • Promotes detection and reduction of adverse drug events such as falls, mental confusion and delirium, and patterns of overuse and underuse of prescription drugs
  • Offers health risk assessments, prescription drug treatment plans, managing high cost specialty medications and evaluating and monitoring patient response to drug therapy.
  • Sends communications to prescribers discussing medication risks and suggested alternatives or corrective therapy recommendations.
  • Performs Targeted Medication Reviews (TMRs) based upon specific clinical issues. These are sent as letters or faxes to you or your prescriber regarding the information reviewed. If the specific issue is deemed to warrant additional outreach, a follow up call may be necessary to you or your prescriber to ensure optimum therapy is achieved.

Additional Information

Once enrolled, members receive quarterly mailings and newsletters in addition to a welcome enrollment kit. Materials focus on disease education, wellness and prevention, proper medication utilization, proper diet and exercise as well as lifestyle modifications. Members receive written materials when interventions or other opportunities are noted and include refill reminders and cost savings opportunities. Members in the MTM program will also receive information on the safe disposal of prescription medications that are controlled substances.

The MTM Program is not considered a Medicare benefit. It is available at no additional fee to those beneficiaries who meet the criteria above. The program is voluntary and beneficiaries can opt out at any time. Although you don’t have to participate, it is recommended that you take full advantage of this free service if you are selected.

Personal Medication List

Even if you don’t participate in the MTM program, it is still a good idea to create a Personal Medication List to help you and your caregivers keep track of what medications you need to take. Having a Personal Medication List can reduce your medication risks and prevent medical errors.

Here are a few helpful tips to help you get started:
  • Download and print a Personal Medication List and list all your prescription medications, over-the-counter drugs, herbals, vitamins and minerals.
  • Record any drug allergies or side effects you have.
  • Keep this list up-to-date.
  • Use blank rows to add new medications and record dates you started using them. Cross out medications you no longer use and record the date and why you stopped using them.
  • Ask your doctors, pharmacists and other health care providers to update this list at every visit.
  • Keep the list in your wallet or purse.
  • If you go to the hospital or emergency room, take this list with you.
  • Share this list with your family or caregivers.

 Last updated: 10/1/23