Memorial Hermann Advantage offers a Medication Therapy Management (MTM) program at no additional cost to help ensure our patients and members achieve the best possible outcomes from their medications. The MTM program is required by the Centers for Medicare and Medicaid Services (CMS) and is not considered a benefit.

Questions? Contact Customer Service at (855) 645-8448

Medication Therapy Management (MTM) Program

Memorial Hermann Advantage offers this free service to our members to help you make sure your medications are working for you, help you find lower cost options, and answer any questions or concerns you may have about your medications. It can also help protect members from the possible risks of drug side effects and potentially harmful drug combinations. 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.

How do you qualify for the MTM program?

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

  1. Have a documented illness from at least three of the following chronic diseases:
    • Diabetes
    • High Cholesterol
    • Osteoporosis-Arthritis
    • High Blood Pressure
    • Alzheimer's Disease
  2. Take eight or more Part D medications
  3. Have had an accumulated drug cost of at least $1,094 in the previous three months ($4,376 per year)

What does the MTM program do?

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

Who is MedWiseRx?

MedWiseRx™ conducts the MTM service on behalf of Memorial Hermann Health Plan at no cost to you. They review your medications and health conditions to find ways to improve your health, lower risk of drug related problems, provide tips to help you take your medications and save money on your prescriptions. This review is done in the comfort of your home in just one phone call. MedWiseRx™ may also be known as Tabula Rasa HealthCare and SinfoniaRx and works with all of our MTM qualified patients. For more information on MedWiseRx™, please visit their website.

When and how do I get notified that I am qualified for this program?

Within 60 days of becoming eligible, you'll receive an offer by mail to complete a Comprehensive Medication Review (CMR). We may also attempt to contact qualified members, or their caregivers, via phone, text, or other electronic method of communication to offer their CMR.

What services are offered to me with MTM program?

We will offer you a free telephone consultation with a healthcare professional. 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 receive a takeaway letter which includes a Personal Medication List (PML) and a Medication Action Plan (MAP) through mail, email, web portal access, or in person delivery. 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) at least quarterly where we review all your prescription medications and contact you, your caregiver, your pharmacist, and/or your doctor if we detect a potential problem. Your doctor may be contacted if we identify any potential drug interaction issues with your medications or if other interventions or safety concerns are noted during this review. Furthermore, additional modes of support are provided to ensure accessibility and care delivery to our members. Please note that not all plan members will qualify for the program, therefore the program is not considered a plan benefit.

How do I Opt Out of this program?

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 MedWiseRx™ at (844) 866-3735 (TTY (800) 367-8939). The MTM service is available Monday through Friday, 9 a.m. to 7 p.m., CT. For more detailed information, refer to Chapter 5 of your Evidence of Coverage.

Who do I contact for more questions?

If you take many medications for more than one chronic health condition contact your drug plan to see if you’re eligible for MTM, or for more information, please contact MedWiseRx™ at (844) 866-3735 (TTY (800) 367-8939). Their Hours of Operation are Monday through Friday, 9 a.m. to 7 p.m. CT.

You may also call the plan to discuss about MTM services and request more information by calling Customer Service department at (855) 645-8448 (TTY 711) for assistance. Hours of operation are 7 days a week from 8 a.m. to 8 p.m. CT, during October 1 – March 31 and Monday – Friday from 8 a.m. to 8 p.m. CT, during April 1 – September 30.

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