Medication Therapy Management is free to qualifying members.

How the program supports your medication needs.

Medication Therapy Management (MTM) is a free plan benefit for members who qualify based on their conditions, medications, and prescription spending. The MTM Program helps prevent or reduce drug-related risks and supports good lifestyle habits.

The benefit includes an in-person or phone consult with a pharmacist to review all your prescription and over-the-counter medications. The pharmacist will help you understand your medications, how best to take them, and if there are ways to lower your medication costs.

This consult is called a Comprehensive Medication Review (CMR). CMRs are recommended each year if you continue to qualify. Health conditions and medications can change over the year, so this gives you a chance to update your information and address any new concerns.

After your CMR appointment, an updated medication list and a review of what was discussed during the appointment will be mailed to you with any other requested documents. A copy will also be sent to your primary care provider along with a call to discuss any important topics if necessary.

Do you qualify for the Medication Therapy Management benefit?

We will automatically enroll you in the program at no cost if at least one of the following applies:

1. You have coverage limitation(s) for medication(s) with a high risk for dependence and/or abuse.

2. You take eight or more Medicare Part D-covered maintenance drugs, AND you have three or more of these long-term health conditions:

   • Alzheimer’s disease
   • Bone disease—arthritis (osteoarthritis, osteoporosis, rheumatoid arthritis)
   • Chronic congestive heart failure
   • Diabetes
   • Dyslipidemia (high cholesterol)
   • End-stage renal disease
   • HIV/AIDS
   • Hypertension
   • Mental health (depression, schizophrenia, bipolar disorder, chronic/disabling mental health conditions)
   • Respiratory disease (asthma, COPD, chronic lung disorders)

3. You are likely to spend more than $1,267 in Part D prescription drug costs in 2026.

_{NOTE: YOUR PARTICIPATION IS VOLUNTARY AND DOES NOT AFFECT YOUR COVERAGE.}