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Medication Therapy Management Program

Our plan has programs that help you manage your Part D medications in special situations. You may have several complex medical conditions. If so, you may need to take many prescription drugs to treat those conditions. You also could have high drug costs.

A team of pharmacists and doctors created a program to help members like you with your healthcare. This is called the Medication Therapy Management Program, or MTMP. Our MTMP pharmacists help our members and their doctors choose the drugs that work best to treat their conditions. They also help find possible errors and improve drug adherence.

The program is not a benefit. The service is voluntary and at no cost to eligible members who:

  • Have three or more of these conditions:
    • Chronic obstructive pulmonary disease (COPD)
    • Depression
    • Diabetes
    • End-stage renal disease (ESRD)
    • High cholesterol (hyperlipidemia)
    • Osteoporosis
    • Hypertension
  • Take eight or more chronic or maintenance Part D medications
  • Spend more than $4,255 each year on drugs

If you meet the above list, we enroll you in our program. From there, one of our MTMP pharmacists reviews your drug history and sends you a welcome letter. The letter tells you about any potential drug problems found and invites you to call for a full review. If you don’t want to continue, just tell us. We will remove you from the program.

If you want to continue, one of our pharmacists or pharmacy interns, under the direct supervision of a pharmacist, will connect you with the following services. The goal is to help you reach the best results to fit your needs:

  • Annual Comprehensive Medication Review (CMR). Done by phone or face-to-face, a CMR creates a collection of all of your medication-related information. The pharmacist will go over your drugs and health conditions. The CMR takes about 45 minutes. You can talk about any of your concerns.
  • Personal Medication List (PML). A list of all your prescriptions and over-the-counter drugs will be reviewed. The PML can be updated as needed. Sample PML (PDF)
  • Medication Action Plan (MAP). Our MTMP pharmacist creates your MAP. It helps you follow steps in taking medications to reach your health goals. 
  • We print your PML and MAP and either mail or hand-deliver them to you within 14 days of your CMR.
  • Quarterly Targeted Medication Reviews (TMR). This review helps find possible safety concerns. They include drugs that people over age 65 should not take. The TMR also may offer other drug therapies that you should be on for your conditions but aren’t. If our MTMP pharmacists find issues, we send you a letter with ways to help improve your drug use. We may also fax any issues to your doctor.

If you want to be in our MTMP but are unable to, you can authorize someone on your behalf. Our MTMP pharmacist may work with other team members if you need more help or services.

If you have questions about the MTMP, contact Member Services. We are here to help.

 

If you have any questions, call Member Services at 1-855-735-4398. Hours are from 8 a.m. to 8 p.m., Monday through Friday. After hours, on weekends and on federal holidays, you may be asked to leave a message. Your call will be returned within the next business day. TTY users call 711.