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The Medication Therapy Management (MTM) program reviews the medicines you take to make sure that they're safe, they work well, and they fit your lifestyle. This program is offered at no additional cost to eligible members. This service is not considered a benefit.
The goal is to help you get the best results from your medicines, at the lowest possible price. The MTM program is right for you if you need answers to these questions:
The program can also help you and your doctor make sure that your medicines are the best choice for you.
You're automatically enrolled in the MTM program if you meet the following criteria.
2024
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Have 3 or more of the following conditions:
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AND
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Take 8 or more prescription medications covered by Medicare Part D.
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AND
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Expect to spend more than $5,330 in 2024 on prescription medicines covered by Medicare Part D.
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AND/OR
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Have an active coverage limitation for an opioid or frequently abused medicine as a result of a Drug Management Program.
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The MTM program is a two-part program. Reviews may be done over the phone, whenever it’s convenient for you. In some cases, you may have an in-person review.
To prepare for your review, make a list of all the prescription medicines you take, along with over-the-counter medicines or supplements. Include the dosage of each and how often you take them.
After your review, you’ll get a complete list of your medicines and an action plan that you can take with you to your next doctor’s visit. Download a personal medication list by selecting your plan.
Every few months, the program reviews your prescription claims to make sure there are no issues that need attention. If the review identifies any issues, we may contact your doctor.
If you’re eligible for the MTM program, you’re automatically enrolled. You’ll get a letter or phone call letting you know how to schedule an appointment or opt out of the program.
Medicare requires us to automatically enroll you if you’re eligible. But, this program is voluntary — you’re not required to participate. You may also choose to take part in only certain services you find valuable. You can change your enrollment status at any time during the calendar year. Your prescription drug coverage will not change if you take part in the MTM program.
Our purpose is to help you get the medicine you need to feel better and live well.
Learn more about Medication Therapy Management.
For additional information, contact us.
The MTM program is offered to members who qualify at no extra cost. It’s not considered a benefit.
Last Updated: Jan. 04, 2024
Last Updated: 03222024
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