If you take medications for different medical conditions, you may be eligible to get help, at no cost to you, through our Medication Therapy Management (MTM) program. The program helps you and your doctors make sure that your medications are working to improve your health. The MTM program is not a benefit. Your participation is voluntary, and does not affect your coverage.
To be eligible for the MTM program, you must:
- Have at least 2 (two) of the following specific chronic diseases:
- Chronic Heart Failure (CHF)
- Respiratory Disease-Asthma
- Respiratory Disease-Chronic Lung Disorders
- Respiratory Disease-Chronic Obstructive Pulmonary Disease (COPD)
- Be on at least 6 (six) chronic maintenance medications
- Have incurred one-fourth of the specified annual cost threshold of Part D drugs in previous three (3) months. For 2017, the amount is $3,919.00
We will contact you if you are eligible to participate in this program. A pharmacist or other health professional will call you and conduct a Comprehensive Medical Review (CMR) of all your medications and talk with you about:
- How to get the most benefit from the drugs you take
- Any concerns you have, like drug reactions or potential side effects
- How best to take your medications
- Any other questions you have about your prescription and over-the-counter medications
After the CMR is completed, we will send you general education information, and a letter to describe your medication regimen, highlight any problems identified, and set goals. Targeted Medication Reviews may also be performed when follow up is required.
To obtain MTM documents or for further information, call us at:
8 a.m. to 8 p.m. 7 days a week.
Quality Assurance and Drug Utilization Management Information: The Quality Assurance program that is designed to ensure our members receive high quality, medically appropriate and cost effective health care.