Medication Therapy Management (MTM)

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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.

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 $1,094 in the previous three months ($4,376 per year)

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 (844) 866-3735 (TTY (800) 367-8939). The MTM department 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.

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. 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.

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 the MTM Department at (844) 866-3735 (TTY (800) 367-8939). Their Hours of Operation are Monday through Friday, 9 a.m. to 7 p.m. CT.

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