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.