Medication Therapy Management Program (MTMP)

Our plan has programs that help you manage your Part D medications in special situations. For example, 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 developed 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 medical conditions. They also help identify possible errors and improve medication adherence.

The program is not a benefit. It’s an extra service that is voluntary and at no cost to eligible members who:

• Have three or more of these medical 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 drugs
• Spend more than $4,696 each year on drugs

If you meet the above criteria, we enroll you in our program automatically. From there, one of our MTMP pharmacists reviews your medication history and sends you a welcome letter. The letter describes any potential medication related problems found and invites you to call for a full review. We may also reach out to you in other ways about your medications. If you do not want us to contact you, 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). Conducted by phone or face-to-face, a CMR creates a collection of all of your medication-related information. The pharmacist will go over your medications and medical conditions. The CMR takes approximately 45 minutes and addresses any of your concerns.
• Personal Medication List (PML). A list of all your prescriptions and over-the-counter medications discussed during the review. The PML can be updated as needed. Sample PML (PDF)
• Medication Action Plan (MAP). One of our MTMP pharmacists 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). TMRs identify potential safety concerns for you. They include drugs that people over age 65 should generally not take, or drug therapies that you should be on based on your conditions but aren’t. If our MTMP pharmacists find issues, we send you a letter with ways to help improve your medication use. We may also fax any issues to your doctor.

If you want to participate in our MTMP but are unable to, you can authorize someone on your behalf. Our MTMP pharmacist who helps you may work with other team members if you need more services to help you reach your health goals.

Medication Therapy Management Program (MTMP)

Our plan has programs that help you manage your Part D medications in special situations. For example, 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 developed a program to help members like you with your healthcare. This is called the Medication Therapy Management Program, or MTMP. Our MTMP pharmacists help you and your doctor choose the drugs that work best to treat your medical conditions. They also help you get the greatest health benefit from your medications by:

• Preventing or reducing drug-related risks (and errors)
• Increasing your awareness
• Supporting good habits

The program is not a benefit. It’s an extra service that is voluntary and at no cost to eligible members who:

• Have three or more of these medical conditions:
  • Chronic Obstructive Pulmonary Disease (COPD)
  • Depression
  • Diabetes
  • High cholesterol (hyperlipidemia)
  • Osteoporosis
• Take eight or more chronic or maintenance Part D drugs
• Spend more than $4,935 each year on drugs

If you meet the above criteria, we enroll you in our program automatically. From there, one of our MTMP pharmacists reviews your medication history and sends you a welcome letter. The letter describes any potential medication related problems found and invites you to call for a full review. We may also reach out to you in other ways about your medications. If you do not want us to contact you, just tell us. We will remove you from the program.

The goal is to help you reach the best results to fit your needs. 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:

• Annual Comprehensive Medication Review (CMR). Conducted by phone or face-to-face, a CMR creates a collection of all of your medication-related information. The pharmacist will go over your medications and medical conditions and may contact your prescribing doctor. The CMR takes approximately 30 minutes, is usually offered once each year—if you qualify, and addresses concerns you may have about the medications you take, including:
  • Prescription drugs
  • Over-the-counter (OTC) medicines
  • Herbal therapies
  • Dietary supplements and vitamins
• Personal Medication List (PML). You’ll receive a list of all your prescriptions and over-the-counter medications discussed during the review. The PML can be updated as needed. Here is a Sample PML (PDF)
• Medication Action Plan (MAP). One of our MTMP pharmacists creates your MAP. It helps you follow steps in taking medications to reach your health goals. It may also include suggestions from the pharmacist for you and your doctor to discuss at your next visit.

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). TMRs identify potential concerns. Our MTMP pharmacists will mail, fax or call you and your doctor with suggestions about drug therapies 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 will not change unless you and your doctor decide to change them.

A review with a pharmacist is important. Different doctors may write prescriptions for you without knowing all the prescriptions and/or OTC medications you take. For this reason, a pharmacist will:

• Discuss how your prescription and /or OTC medications may affect each other.
• Explain how your prescription and/or OTC medications may cause side effects and offer suggestions.
• Help you get the most benefit from all of your prescription and/or OTC medications.
• Review opportunities to help reduce your prescription drug costs.

Reviewing your medications with a pharmacist can result in real peace of mind and the knowledge you need to take medications safely. If you want to participate in our MTMP but need assistance, you can authorize someone on your behalf. Your MTMP pharmacist can work with other authorized team members to help you reach your health goals.

Please contact us if you would like additional information about our MTMP program, or if you do not want to participate after being enrolled in the program.  Our number is 1-844-635-3406, 24 hours a day, 7 days a week. (TTY users call 711.)