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Medication Therapy Management Program 2021

Medica HealthCare's Medication Therapy Management (MTM) program was developed by a team of pharmacists and doctors to help eligible members utilize their coverage and gain an understanding of their medications and how to use them. It can also help protect members from the possible risks of drug side effects and from potentially harmful drug combinations.

This program is not a plan benefit and is available at no additional cost to you. You will be automatically enrolled in the Medication Therapy Management Program if you:

  • take eight (8) or more chronic Part D medications, and
  • have three (3) or more long-term health conditions, and
  • might spend more than $4,376 a year on covered Part D medications

Below is a list of health conditions that may make you eligible for the Medication Therapy Management program. You need to have three or more of these conditions to qualify for this program.

  • Chronic Obstructive Pulmonary Disease (COPD)
  • Diabetes
  • Heart Failure
  • High Cholesterol
  • Osteoporosis

Within 60-days of becoming eligible for Medica HealthCare's Medication Therapy Management program, members will receive an offer by mail to complete a Comprehensive Medication Review (CMR). Members may also receive this offer by phone.

Eligible members complete the Comprehensive Medication Review by phone with a qualified health care provider. This review takes approximately 30 minutes to complete. A qualified health care provider will review the member's medication history, including prescription and over-the-counter medications, and identify any issues. Within 14 days of the Comprehensive Medication Review, the member is mailed a Medication Action Plan that summarizes any clinical concerns identified and a Personal Medication List of their medication history. In addition, the member's doctor may be contacted and provided this information.

To help track your medications, you can also download a blank Personal Medication List (PDF) for your personal use.

Additionally, quarterly Targeted Medication Reviews are conducted systematically to identify any drug-drug interactions or other medication concerns. Those results may be mailed to your doctor for review.

Members may also receive helpful information in the mail. This can include additional information about their medications and suggestions from our pharmacists about how to use your medications and benefits. This information can be helpful when meeting with your doctor or pharmacist.

For more information on Medica HealthCare's Medication Therapy Management program, please contact Member Services