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Medication Therapy Management Program

Medication Therapy Management Program (MTM) is a free program for qualifying members. This program helps you and your doctor be sure your medications are working to treat your condition.

  • Are you eligible for the Medication Therapy Management Program?

    Members are eligible for the MTM program if they meet ALL of the following criteria: Have at least three of the following chronic diseases:

    • Alzheimer’s disease
    • Osteoarthritis
    • Osteoporosis
    • Rheumatoid arthritis
    • Diabetes
    • End-stage renal disease
    • Asthma
    • Chronic obstructive pulmonary disease (COPD)
    • Chronic alcohol and other drug dependence
    • HIV/AIDS
    • Are taking at least 8 drugs covered by Medicare Part D
    • Are likely to incur annual Medicare Part D costs greater than or equal to $3,919
  • What services do participants receive with the
    Medication Therapy Management Program?

    Each eligible member may receive the following FREE services:

    • Interactive, person-to-person comprehensive medication review with a qualified MTM provider, which is designed to improve patients’ knowledge of their prescriptions, over-the-counter medications, herbal therapies and dietary supplements. The review helps identify and address problems or concerns that  patients may have, and empowers them to self-manage their medications and health.
    • Quarterly screenings for actual or potential medication-related problems with notifications sent to the participant’s care team.
  • How will participants be notified that they are eligible and enrolled in the Medication Therapy Management Program?
    •  We will mail a letter within 60 days of program enrollment offering members a comprehensive medication review.
    • We may also call members regarding a date to schedule their comprehensive medication review.
    • The comprehensive medication review will take place in person, by telephone, or by other means. The review is a discussion between the member or authorized representative and the qualified MTM provider. The review usually takes 30 to 60 minutes.
    • After the comprehensive medication review, participants will receive a written summary of the findings. This includes a cover letter, medication action plan and personal medication list. Download a blank copy of the Personalized Medication List (pdf).
    • Targeted medication reviews are performed with the participant’s care team to notify them of actual or potential medication-related problems.

The Medication Therapy Management Program is not considered a benefit.



High-Risk Medications in Older Adults

Below is a list of medications considered high risk for older patients enrolled in the Senior Care Options (SCO) program and safer alternatives.

Primary care provider letter (pdf)

High Risk Medication in the Elderly
and Possible Alternatives (pdf)


For more information, please call our Member Services team at 866-610-2273 (TTY 711). We're available 8 a.m. to 8 p.m., 7 days a week.



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