Medication Therapy Management Program

The Medication Therapy Management (MTM) program helps you get the greatest health benefit from your medications by:

• Preventing or reducing drug-related risks
• Increasing your awareness
• Supporting good habits

We'll automatically enroll you in the MTM program at no cost to you if all three of the following conditions apply or if you are considered to be at-risk of misuse of frequently abused drugs:

1. You take eight or more Medicare Part D-covered maintenance drugs
2. You have three or more of these long-term health conditions:
• Asthma
• At-risk for opioid overuse
• Chronic heart failure
• Chronic obstructive pulmonary disease (COPD)
• Depression
• Diabetes
• Dyslipidemia (high triglycerides or cholesterol)
• Hypertension (high blood pressure)
• Osteoporosis
• End-stage renal disease (ESRD)
3. You're on track to reach $4,935 in yearly prescription drug costs paid by you and the plan

Your participation is voluntary. It doesn't affect your coverage, and there's no cost to you. It's also open only to members who are invited to participate.

The MTM program gives you a comprehensive medication review and a targeted medication review. 

This is a one-on-one discussion with a pharmacist. They'll answer questions and address concerns about the medications you take, including:

• Prescription drugs
• Over-the-counter (OTC) medicines
• Herbal therapies
• Dietary supplements and vitamins

The pharmacist will also offer ways to manage your conditions with the medications you take. If they need more information, the pharmacist may contact your prescribing doctor. The review takes about 30 minutes, and it's usually offered once each year. At the end of your discussion, the pharmacist will give you a Personal Medication List of the medications you discussed.

You'll also get a Medication Action Plan. Your plan may include the pharmacist's suggestions for you and your doctor to discuss during your next visit.

To track your prescriptions, use our Personal Medication List template.

With this review, we contact your doctor with suggestions about prescription drugs that may be safer or work better than your current drugs. As always, your prescribing doctor will decide whether to consider our suggestions. Your prescription drugs won’t change unless you and your doctor decide to change them. We may also contact you with suggestions about your medications.