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 $4,376 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”).

You are also eligible if you are in a Medicare Part D plan and have high opioid usage. The following three situations qualify you for the MTM Program:

  • Opioid pharmacy claims equal to or greater than 90 Morphine Milligram Equivalents**, and
  • Three or more opioid prescribers, and
  • Three or more opioid dispensing pharmacies


  • Opioid pharmacy claims equal to or greater than 90 Morphine Milligram Equivalents **, and
  • Five or more opioid prescribers,


  • Any Morphine Milligram Equivalent** level, and
  • Seven or more opioid prescribers or seven or more opioid dispensing pharmacies

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

**Morphine Milligram Equivalents are a way to compare different opioid medications based on their strength as compared to morphine.

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.

The purpose of the phone consultation, which usually takes only 30 minutes or less, 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. We encourage you to complete your MTM review prior to your yearly check-up.  You can use the summary to discuss your drug therapy with your provider.

You will also receive one or more quarterly targeted medication reviews.  These are usually fax notifications to your provider. Depending on the reason for the follow-up, you may receive a phone consultation or a mailed letter.

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–March 31, 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.

Call us toll-free at 1-888-340-5504 (TRS 711), 8 a.m.–8 p.m., seven days a week
(From Jan.–Sept., 8 a.m.–5 p.m., Mon.–Fri.)

H9001_210085_C | The information on this page was last updated on 10/1/2020.