Medication Therapy Management Program

Our Medication Therapy Management (MTM) Program is not a benefit but is a free service that is designed to help you stay healthy while taking multiple prescription medications. The program is free to eligible members.

Who is eligible for the MTM Program?

Members who are:

  • Enrolled in a Medicare Part D plan,
  • Taking at least eight prescriptions,
  • Have three or more chronic conditions*
  • And are spending an annual amount of $3,919 or more on prescriptions are eligible.

If you're eligible, you'll receive a letter from us explaining the program and notifying you that you have been enrolled in the program. After you receive the letter, a member of the Medication Therapy Management team will contact you by phone, unless you call the number on the letter saying that you don’t want to participate (“opt out”).

* Qualifying chronic conditions include: high blood pressure, high cholesterol, diabetes, heart failure, COPD (chronic obstructive pulmonary disease) and depression.

What do I receive as an MTM Program participant?

Enrolled members will receive at least one comprehensive, interactive phone consultation with a clinical team member and one or more quarterly medication reviews.

The purpose of the phone consultation, which takes only 15-20 minutes, is to gather information to conduct a comprehensive medication review. The medication review is not intended to interfere with the care already provided by your doctors.

The medication review may include:

  • Checking for drug-to-drug interactions, including interactions with your over-the-counter medications
  • Offering solutions that may reduce any side effects from your medications
  • Identifying less expensive medication alternatives
  • Presenting ways to simplify your medication regimen
  • Monitoring your medications and medical conditions (such as high blood pressure, high cholesterol or diabetes) to be sure you’re getting the most out of your medications

We'll give you a written summary of the review and a list of any recommendations made by the pharmacists.

Who can I contact for more information about MTM?

For more details, call us toll-free at 1-800-325-5669 (TRS 711), 8 a.m.–8 p.m., Monday–Friday. (Oct. 1–Feb. 14, seven days a week.)

You can also call us to get copies of letters that we have sent you, to get blank medication lists or to get educational materials. You may also print a blank medication list (pdf). The blank medication list is to help you keep track of the medications you are taking.

Fallon Health is an HMO/HMO-POS plan with a Medicare contract. Enrollment in Fallon Health depends on contract renewal. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits may change on January 1 of each year.

H9001_F_2017_21 Approved 10172016
The information on this page was last updated on 10/1/2016.

Call us toll-free at 1-888-340-5504 (TRS 711), 8 a.m.–8 p.m., Monday–Friday. (Oct. 1–Feb. 14, seven days a week.)

Helpful information about medications and our online drug formulary

Medicare Part D online forms