Medication Therapy Management (MTM)

You can enroll in this program if you meet all of the following criteria:

• Take eight or more Medicare Part D-covered medications
• Have three or more of the following conditions or diseases:
  • Chronic heart failure (CHF)
  • Diabetes
  • Dyslipidemia (high cholesterol)
  • Hypertension (high blood pressure)
  • Asthma
  • Chronic obstructive pulmonary disease (COPD)
• Have medications with a total cost more than the amounts listed below on your Part D-covered medications
  • For 2021 plan members: $4,376
  • For 2022 plan members: $4,696

If you meet these criteria, we will send you a letter inviting you to take part in the program and giving you more information about how it can help keep you healthy. Enrollment in MTM is voluntary, but we strongly encourage you to take advantage of this free service.

No, enrollment in MTM does not affect your Medicare coverage for drugs.

We will review your prescription medications every three months, and if we find a potential problem, we will contact you, your caregiver if you wish, your pharmacist, and maybe your doctor, as well.

Once a year, a pharmacist or other health professional from our partner MedWiseRx will call you to discuss ways to use your medications safely. This conversation can also be in person or by telehealth at your pharmacy or doctor’s office if that works better for you. The conversation usually lasts about 30 minutes. If you are unable to have this conversation, our partners may complete the review with your doctor instead.

After the annual review, you will get a written summary of this call, which you can take with you when you talk with your doctors. This summary includes:

• Medication Action Plan (MAP) with steps you should take to help you get the best results from your medications.
• Personal Medication List (PML) to help you keep track of your medications and how to use them the right way.

To obtain a blank copy of the PML for you and your health care providers so you can keep track of your medications, click here.