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Medication Therapy Management

Who is eligible?

Members are eligible for the program if they:

  • Have three or more of the following health conditions: asthma, chronic heart failure, diabetes, high cholesterol or high triglycerides, or rheumatoid arthritis
  • Are taking eight or more medications that are covered by Medicare Part D that are for treating one of the health conditions listed above
  • Are likely to have annual costs for medications covered by Medicare Part D that are greater than the dollar limit set by Medicare

Eligible members are automatically enrolled in the program but can leave or re-enroll in the program at any time. They are notified of their enrollment by letter and must meet eligibility requirements for the program from year to year. Peoples Health may focus on different medications or health conditions each year.

What is the Medication Therapy Management Program?

The Peoples Health Medication Therapy Management (MTM) program helps eligible plan members take care of their health through improved medication use. The program is a free service for eligible members.

The MTM program has two parts: targeted medication reviews and a comprehensive medication review.

Targeted medication reviews

Targeted medication reviews are performed every three months to review medication use, check unresolved medication issues, and find any problems with new medications the member is taking. All members in the MTM program automatically receive these reviews, which do not require the member to speak with anyone. A Peoples Health clinical representative conducts a review by using our medication records for the member. The representative may discuss the review results with the member’s doctor, who may contact the member to follow up on the results. Targeted reviews focus on drug use specific to program-defined health conditions.

comprehensive medication reviews

Comprehensive medication reviews are an optional service offered. Members are notified about this review by mail. If a member chooses to take part in the review, a Peoples Health clinical representative conducts the review with the member by phone or face to face. During the review, the representative discusses all medications—including over-the-counter medications, vitamins and herbal supplements— to identify potential medication-related problems and evaluate medication effectiveness. The representative also uses available lab and test results to conduct the review and may discuss review results with the member’s doctor. The amount of time it takes to complete the review varies depending on the member’s needs. Members who complete the review receive a follow-up letter, medication action plan and personal medication list based on the review. They can also complete a personal medication list on their own. This is a helpful tool for keeping track of medications and how to use them the right way.

Members enrolled in the program may also receive targeted educational materials on applicable chronic conditions.

For more information about the MTM program, including how to obtain a blank personal medication list, call us toll-free at 1-800-222-8600, seven days a week, from 8 a.m. to 8 p.m. TTY users should call 711. If you call on a weekend or holiday, we will reach out to you within one business day.

The MTM program is not considered a plan benefit.


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