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Medication Therapy Management

Program details

If you qualify, our medication therapy management program offers a one-on-one session with a pharmacist.

The program helps you get the most health benefits from your medications by stopping or cutting down on drug-related risks. It also explains the benefits of taking your medications as prescribed. You don't have to join. If you decide not to, your coverage won't be affected. But we'll automatically sign you up for the program, at no cost to you, if all three of these conditions apply:

  1. Be identified as an at risk beneficiary* in Medica's Opioid Drug Management Program, OR
  2. Be using at least eight chronic Part D medications, AND
  3. Have incurred at least $1,174 in Part D-eligible drug costs in the prior 3 months, AND
  4. At least three of the following chronic conditions:
    • Osteoporosis
    • Chronic Heart Failure
    • Diabetes
    • Dyslipidemia (cholesterol disorders)
    • End-stage Renal Disease
    • Hypertension
    • Depression
    • Asthma
    • Chronic Obstructive Pulmonary Disease (COPD)

*Beneficiaries with an active coverage limitation under a Drug Management Program starting January 1, 2022 (though limitation may have been in place prior to January 1, 2022), and at risk beneficiaries identified on or after January 1, 2022.

The program gives you:

  • Complete medication review. This is a one-on-one talk with a pharmacist. You can ask questions and address worries you have about the medications you take. The review takes about 30 minutes and happens once a year. At the end of your meeting, the pharmacist will give you a personal medication list and an action plan. Your plan may include suggestions for you and your provider to discuss during your next visit. Check your Document Center for our personal medication list template to track your prescriptions.
  • Targeted medication review. With this review, we mail, fax, or call your provider with suggestions about prescription drugs that may be safer or work better than your current drugs. Your prescription drugs won't change unless you and your provider decide to change them. We may also mail or call you with suggestions about your medications.

Frequently asked questions

  • If you qualify, we will mail you a letter. You may also receive a call inviting you to participate in this one-on-one medication review.
  • You may receive a call from a pharmacy where you recently filled one or more of your prescriptions. You will be given the option to choose an in-person review or a phone review.

    You may be contacted by a call center pharmacist to provide your review and ensure that you have access to the service if you want to participate. These reviews are conducted by phone.

  • Different doctors may write prescriptions for you without knowing all the prescription drugs and/or OTC medications you take. For that reason, a pharmacist will:

    • Discuss how your prescription drugs and OTC medications may affect each other
    • Identify any prescription drugs and OTC medications that may cause side effects and offer suggestions to help
    • Help you get the most benefit from all of your prescription drugs and OTC medications
    • Review opportunities to help you reduce your prescription drug costs
    • Discussing your medications can result in real peace of mind knowing that you are taking your prescription drugs and OTC medications safely
    • The pharmacy can look for ways to help you save money on your out-of-pocket prescription drug costs
    • You benefit by having a Personal Medication List and a Medication Action Plan to keep and share with your doctors and health care providers
  • Please contact us if you would like additional information about our MTM program, or if you do not want to participate after being enrolled in the program. Call us 1-888-347-3630 (toll-free) (TTY: 711), 8 a.m. to 8 p.m. Central, seven days a week. Access to representatives may be limited at times.

Last updated: November 2021