Medication Therapy Management (MTM)
Summary
The Medication Therapy Management (MTM) Program is a free, voluntary Medicare Part D benefit available to eligible members enrolled in an Elderplan plan that includes Medicare prescription drug coverage.
The program is designed to help members with complex medication needs get the most benefit from their medications safely and effectively. A pharmacist or other qualified health care professional reviews your medications and works with you to identify potential issues, improve medication safety, and answer questions about your treatment.
Participation is completely voluntary and does not affect your health plan coverage.
How the MTM Program Can Help
The MTM Program can help you:
- Better understand your medications and how they work
- Identify potential drug interactions or side effects
- Improve medication safety and effectiveness
- Review opportunities to lower prescription drug costs
- Keep an accurate medication list to share with your care team
The goal is to help ensure your medications work together safely and support your overall health.
Do You Qualify?
You may qualify for the MTM Program if you have complex medication needs and meet Medicare eligibility requirements.
In general, eligibility may be based on:
- Having multiple chronic health conditions
- Taking multiple Medicare Part D-covered medications
- Reaching an annual prescription drug cost threshold established by Medicare
Eligibility requirements are reviewed annually and may change from year to year.
Examples of qualifying chronic conditions may include:
- Alzheimer's disease
- Arthritis and other chronic bone diseases
- Chronic heart failure
- Diabetes
- High blood pressure
- High cholesterol
- End-stage renal disease (ESRD)
- HIV/AIDS
- Mental health conditions
- Asthma or chronic obstructive pulmonary disease (COPD)
If you qualify, you will automatically be enrolled and receive information about the program.
What Services Are Included?
Eligible members receive two types of medication reviews.
Comprehensive Medication Review (CMR)
The Comprehensive Medication Review is a one-on-one consultation offered at least once a year with a pharmacist or other qualified health care professional.
During the review, you'll discuss all of your medications, including:
- Prescription medications
- Over-the-counter medications
- Herbal products
- Dietary supplements
You can ask questions about your medications, side effects, and health conditions.
After the review, you'll receive:
- A personalized Medication List
- A Recommended To-Do List you can discuss with your doctor
Targeted Medication Review (TMR)
The Targeted Medication Review is an ongoing review of your medications quarterly.
Pharmacists evaluate your medications for potential concerns, such as:
- Drug interactions
- Duplicate therapies
- Medication safety issues
- Opportunities to improve treatment
If recommendations are identified, they may be shared with your prescribing provider. You and your doctor should always make any changes to your medications.
Safe Medication Disposal
Unused medications should be disposed of safely to help protect others and reduce the risk of accidental misuse.
Drug take-back programs are the preferred disposal method and are available through many pharmacies, law enforcement agencies, and community organizations.
If a take-back option is not available, follow the disposal instructions provided with the medication and remove personal information from prescription labels before disposal.
Frequently Asked Questions
How will I know if I qualify?
If you qualify, you will automatically be enrolled and receive a letter with information about the program. You may also receive a call to schedule a medication review.
Why is this review important?
Many people receive medications from multiple providers. The MTM Program helps ensure that all medications are reviewed together to identify potential concerns and improve medication safety.
What are the benefits of participating?
Participation can help you better understand your medications, identify potential issues, improve communication with your health care team, and explore opportunities to reduce prescription drug costs.
What if I don't want to participate?
The MTM Program is voluntary. You may choose not to participate at any time without affecting your health plan coverage.
For assistance, contact Member Services.