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Medicare Advantage 2018

Medication Therapy Management (MTM) Information

Memorial Hermann Advantage is excited to offer a Medication Therapy Management (MTM) program at no additional cost. Some members who take several medications for different medical conditions may qualify. You may be eligible to participate in this program designed for your specific health and pharmacy needs. The MTM program was developed by a team of pharmacists and doctors to assist members who may benefit from additional support with their Part D medications.

To qualify for the MTM program, you are required to meet the following criteria established by Medicare:

  • Have a documented illness from at least three of the following chronic diseases:
    •  Diabetes
    •  High cholesterol
    •  Osteoporosis-Arthritis
    •  High blood pressure
    •  Alzheimer's Disease
  • Take eight or more Part D medications
  • Have had an accumulated drug cost of at least $991.75 in the previous quarter

The MTM program provides a broad range of services, including but not limited to:

  • Conducting patient assessment and/or a comprehensive medication review (CMR)
  • Formulating a medication action plan (MAP)
  • Developing a personalized medication record (PMR)
  • Monitoring efficacy and safety of medication therapy
  • Enhancing medication adherence
  • Coordinating care with your physicians

The MTM program aims to help you get the best benefits from your medications. Although we encourage members to take advantage of our valuable program, you do have the option to opt out of it. If you do not want to take part in the program, or if you have questions, please call the MTM Department at (866) 342-2183. TTY/TDD users may call 711. The MTM department is available Monday through Friday, 8 a.m. to 4 p.m., CST. For more detailed information, refer to Chapter 5 of your Evidence of Coverage.

You will be contacted by mail if you qualify. As an eligible MTM member, you are also eligible to receive a comprehensive medication review (CMR). We will offer you a free telephonic consultation with a health care professional by mail, and in some cases, by phone. The CMR will give you the opportunity to review all of your current medications with a pharmacist or other healthcare professional. This is a one-on-one conversation by phone that takes about 30 minutes.

After completing the CMR, you will be mailed a Personal Medication List (PML) and a medication action plan (MAP). The PML will include your current prescription medications, over-the-counter medications, and dietary and herbal supplements. The MAP will summarize what you and the pharmacist discussed during the CMR and discussion topics for you and your doctor. We will also conduct a Targeted Medication Review (TMR) three months after your CMR is completed, then every quarter thereafter. Your doctor may be contacted if we identify any potential drug interaction issues with your medications.

Please note that not all plan members will qualify for the program, therefore the program is not considered a plan benefit.

Download a personal medication list (PML) template.