We want to help you get the best results from your medications. Talking to a trained healthcare provider can help make sure the medications you take are working, identify potential lower-cost options and answer any questions or concerns you may have about your medication routine. This service is available to eligible members at no additional cost.

What Is the Purpose of the MTM Program?

If you are taking multiple chronic medications, an annual medication check-up is a good idea. The MTM Program provides you with personalized advice from a pharmacist who will review your medicines and help you learn more about what you are taking and how they affect you.

The goal is to help you better manage chronic conditions, improve overall health and reduce your out-of-pocket costs, when able. You’ll talk one-on-one over the phone with a pharmacist to review your current medication routine including any over-the-counter (OTC) products you are taking.

During your medication check-up the pharmacist will:
  • Review each medication and what it is used for
  • Answer any questions you may have about your medications
  • Discuss any concerns you may have about your medications, including side effects
  • Talk with you about ways to keep track of your medications
  • Review your medications and OTC products to make sure they are safe for you
  • Share possible lower-cost alternatives for your current medications

The MTM Program can also help you and your doctor make sure that your medicines are the best choice for you. Working together, we can ensure you’re getting the best possible results from all your medications, helping you achieve your health goals.

How Do I Qualify for the MTM Program?

To qualify for the MTM Program, you must meet the following criteria:

  • You have been diagnosed by your doctors with at least three of the following medical conditions: diabetes, high blood pressure, high cholesterol, chronic heart failure, osteoporosis, asthma, COPD, depression, End-Stage Renal Disease (ESRD), Alzheimer’s Disease, or Human immunodeficiency virus/Acquired immunodeficiency syndrome (HIV/AIDS), AND
  • You have filled prescriptions for eight or more chronic/maintenance Part D medicines, AND
  • You and others on your behalf (including your health plan) have paid at least $405.75 for your medicines in the previous three months
  • OR,
  • You are taking multiple and/or high doses of opioid (medicines used to manage pain) medicines prescribed by multiple doctors from multiple pharmacies

If you qualify for the MTM Program, we will automatically enroll you in the program and send you a welcome packet in the mail.

What Is a Comprehensive Medication Review?

A CMR is the main part of the MTM Program where the pharmacist evaluates your full medication profile to identify any potential issues such as drug interactions, duplicate therapy, or non-adherence. A CMR is an interactive over the phone consultation between you (and/or your caregiver) and the pharmacist to review all prescribed medications, over-the-counter (OTC) drugs, herbal therapies and dietary supplements you may be taking. The goal of a CMR is to identify and resolve any medication-related problems, optimize the use of medications, and improve your understanding and adherence to your medication plan.

Interested in a medication review? As an MTM Program enrolled member, you can have a Comprehensive Medication Review (CMR) by phone with a pharmacist or other trained healthcare provider. Contact Customer Service to schedule your review today.

Please have a list of your medicines or your medicine bottles with you at the time of your call. This includes prescription medicines, over-the-counter medicines, and any vitamins or supplements you are taking.

A pharmacist phone consultation usually lasts about 20 to 30 minutes. This call is dedicated to discussing your medications in detail. It will cover how to take them for the best results, discuss any cost-related inquiries, and address any other questions or concerns you may have about your medications. We can help you define and achieve your health goals, providing support in creating actionable plans.

After the call, we will send you a written summary of the discussion. This summary will include a medication action plan that recommends what you can do to make the best use of your medicines, with space for you to take notes or write down any follow-up questions. You will also get a personal medication list that will provide the details we reviewed about all the medicines you are taking and why you take them. No changes will be made to your medicines unless your provider makes them. Download a blank copy of our personal medicine list form here.

How Can I Get More Information About the MTM Program?

To learn more about the MTM Program or for any questions, please contact Customer Service.

Should you need a replacement of any program letters, contact Customer Service. There is no cost for participating in the MTM Program.

What if I’m Enrolled but Don’t Want to Participate?

If you receive an MTM Program welcome packet and choose not to participate, kindly inform us by contacting Customer Service.

Experience the benefits of the MTM Program. Contact Customer Service to re-enroll if you’ve changed your mind about participating.

This program is not considered a benefit.