Medicare prescription drug coverage options in a nutshell. (Video, 3:43)Open video transcript
Medication therapy management
Reduce risks and costs when you take multiple medications
If you take multiple medications, you’re at increased risk for errors that can result in serious complications such as heart attacks, falls, blood clots and kidney failure.
Our Medication Therapy Management program aims to prevent such errors. The program is a collaboration between you, your pharmacist and doctors to ensure you take medications safely while achieving the best possible outcome.
MTM is a free service for eligible members with Medicare Part D prescription drug coverage.
Benefits of MTM include:
- Improved adherence: We’ll help you safely take medications as prescribed.
- Improved safety: MTM can help you avoid dangerous side effects and duplication of medications.
- Lower costs: The program has reduced members’ direct pharmacy costs by an average of 16 percent and indirect medical costs by 21 percent.
Who is eligible for the Medication Therapy Management program?
You’re eligible for MTM if you:
- Use eight or more medications
- Spend more than $4,044 on medications annually in 2019 and $4,025 in 2020
- Have at least three qualifying medical conditions from the list below:
Acid (Reflux/Ulcers), Alzheimer’s Disease, Anemia, Arthritis, Atrial Fibrillation, Benign Essential Tremor, Benign Prostatic Hyperplasia, Bipolar Disorder, Cardiovascular Disorders, Cerebrovascular Disease, Chronic Heart Failure, Chronic non cancer pain, Crohn’s Disease, COPD, Dementia, Depression, Diabetes, Dyslipidemia, End-Stage Renal Disease, Hepatitis C, HIV/AIDS, Hypertension, Incontinence, Insomnia, Multiple Sclerosis, Neurological Disorders, Osteoporosis, Parkinson’s Disease, Plaque Psoriasis
If you’re eligible, we’ll mail a letter explaining the program and its potential benefits. An MTM analyst will then call you to answer your questions and set up an appointment by phone with one of our MTM pharmacists.
You will not need to change doctors or pharmacies to enroll in the MTM program.
How does Medication Therapy Management work?
Once you’re enrolled in MTM, a pharmacist will call you to conduct a Comprehensive Medication Review. During this review, the pharmacist will:
- Discuss your medications and answer questions
- Identify possible drug interactions
- Highlight potential ways to reduce your drug costs
- Determine if any medications need to be adjusted for safety or to improve your health
The pharmacist will work with your doctors to make any necessary medication changes.
After completing the review, you’ll receive a letter containing:
- Your MTM pharmacist’s name and contact information
- An action plan listing all discussed medication-related concerns
- Follow-up steps
You’ll also receive a Personal Medication List that includes:
- Your prescription and over-the-counter medications
- How to take each drug
- Why you are taking each drug
- Who prescribed each drug
The Centers for Medicare & Medicaid Services requires that you receive a Targeted Medication Review every three months if you’re enrolled in MTM. A pharmacist will contact you by phone to conduct these reviews, during which time they will answer questions and help make sure you’re taking your medications as prescribed.