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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. 

Comprehensive 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.

Targeted medication review

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.

Frequently Asked Questions

  • How will I know if I qualify for the MTM program?

    If you qualify, we’ll send you a letter. You may also receive a call inviting you to participate in this one-to-one medication review.

  • Who will contact me about the review?

    One of our call center pharmacists from Medica partner, MedWiseRx, may call you to provide your review.

  • Why is a review with a pharmacist important?

    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 ways to help you lower your prescription drug costs
  • How do I benefit from talking with a pharmacist?
    • Discussing your medications can give you peace of mind knowing you take 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
  • How can I get more information about the program?

    Call us if you want more information — or if you don’t want to participate.

    Still have questions?

    We're here to answer them

    Daily 8 a.m. to 9 p.m. CT
    Access to representatives may be limited at times.

    Call the Member Services number on the back of your Medica identification (ID) card.

Medication Therapy Management, while not part of a prescription drug benefit, is a Medicare-designed program sponsored by Medica.

Medica Dual Solution (HMO D-SNP) and Medica AccessAbility Solution Enhanced (HMO D-SNP) are health plans that contract with both Medicare and the Minnesota Medical Assistance (Medicaid) program to provide benefits of both programs to enrollees. Enrollment in Medica Dual Solution and Medica AccessAbility Solution Enhanced depend on contract renewal. 
American Indians can continue to use tribal and Indian Health Services (IHS) clinics. We will not require prior approval or impose any conditions for you to get services at these clinics. For elders age 65 years and older this includes Elderly Waiver (EW) services accessed through the tribe. If a doctor or other provider in a tribal or IHS clinic refers you to a provider in our network, we will not require you to see your primary care provider prior to the referral. 


H2458_1000973 Approved

Last Updated: June 2022