Medication Therapy Management

If you qualify, you can learn if your medication is right for you with your Medicare Dual Eligible Special Needs Plan (D-SNP) Medication Therapy Management (MTM) Program.

Your D-SNP MTM

A team of pharmacists and doctors built your D-SNP MTM program as an optional medication benefits program. It’s offered at no cost as part of your D-SNP medication benefits. If you are currently taking medication and qualify, you can opt out at any time.

Joining the MTM

For 2023, in order to join the MTM, you must have three of these conditions:

• Asthma
• Bipolar Disorder
• Chronic Heart Failure (CHF)
• Chronic Obstructive Pulmonary Disease (COPD)
• Diabetes
• End-Stage Renal Disease (ESRD)
• HIV/AIDS
• Hypertension
• Multiple Sclerosis

You must also take eight or more maintenance medications and have spent one-fourth of the specified annual cost threshold ($4,935) in previous three months ($1233.75).

When you can join your MTM, you’ll get:

• Automatically enrolled
• A welcome packet in the mail
• A call asking if you’d like to set an appointment. All appointments are over the phone and normally take around 20 minutes.

How Your MTM Works

First, you’ll have a call with a pharmacist or other health care professional to complete a comprehensive medication review (CMR) to:

• Talk about your medication
• Review your prescription drug costs
• Ask questions on medicine or over-the-counter items
• Mention any side-effects

Afterwards, you’ll get recommended to do lists and medication list summary in writing.

Your CRM Summary

Your CRM summary will have details like:

• Tips for taking your medications
• How to prevent side effects
• Ideas on changes to possibly lower costs
• Suggested to do list for next steps

Having this information can help you see your overall health picture. It can also help you and your doctor make any changes.

View CRM Summary Example

Using Your MTM Summary

Keeping your care team informed on your prescription drugs is one way to achieve whole care. Your MTM summary is a tool to use on a regular basis. You can bring it to:

• Doctor visits
• Your pharmacist
• Other health care provider visits
• The hospital or emergency room

You can also use it when you and your doctor review drugs on your Medicare D-SNP Diamond and Ruby Drug List.

Get Questions Answered

If you have questions about your D-SNP MTM or your prescription benefits, please call Member Services at 1-844-339-7684 (TTY 711).