MTM - Medication Therapy Management


What's MTM?

Medication Therapy Management (MTM) is an opportunity to have a specially trained MTM pharmacist thoroughly review and maximize the benefits of your medications. This is a free program provided to our members and is not considered a benefit. The MTM program is made up of several different services. For a list and description of these services, please click here.

How can MTM help me?

MTM can help ensure that you receive the absolute best results from your medications while keeping your out-of-pocket costs low.

Who's eligible?

To be enrolled in PrimeTime Health Plan MTM program members must meet the criteria below.

MTM Eligiblity Requirements:

  • Member must have at least 2 chronic medical conditions, such as bone disease/arthritis/osteoporosis, chronic heart failure, diabetes, high blood pressure (hypertension), or respiratory disease/chronic obstructive pulmonary disease, AND
  • Be taking at least five Part D prescription medications, AND
  • Have an anticipated annual prescription spending of $3,967 or more in 2018.

Among the services available:

  • Comprehensive Medication Review (CMR):
    Your Pharmacist will meet with you face-to-face or via phone to review all your medications. This will help identify any duplications or conflicts and help to organize your medication schedule. Following the CMR, you will receive a Medication Action Plan and Personal Medication List.
    • Estimated Time Commitment: 30 minutes to 1 hour
  • Prescriber Consult:
    Your Pharmacist will confer with you and your doctor(s), face-to-face or via phone to resolve any problems found with your medications.
    • Estimated Time Commitment: 5 to 15 minutes
  • Medication Adherence Guidance:
    Your Pharmacist will ask about how you take certain medications to ensure you take it as prescribed and work with you on any adherence barriers you may encounter.
    • Estimated Time Commitment: 5 to 15 minutes

How will I know if I have been enrolled in the MTM program?

All members who meet the requirements are automatically enrolled in the MTM program. You will receive a letter from PrimeTime Health Plan letting you know that you have been enrolled in the MTM program and that you are eligible to receive a Comprehensive Medication Review (CMR). Your letter will let you know who to contact to have your CMR completed. Often it is your current pharmacist. In addition you may also receive a phone call from your pharmacist or another one of our contracted pharmacists to complete your review.

What is a Comprehensive Medication Review (CMR)?

A CMR is a one-on-one meeting with a registered pharmacist. The pharmacist will go over all of your current prescriptions and all of your over-the-counter (OTC) medications such as vitamins, herbs and allergy medications. They will also answer any questions or concerns you have about your current therapies.

The goal of your Comprehensive Medication Review (CMR) is to go over all of your medications to make sure they are the best choices to help you meet your doctor’s health care goals. At the end of your CMR you will receive a Standardized Patient Takeaway. Your Standardized Patient Takeaway will include a Personal Medication List, which will list all of your current medications, and a Medication Action Plan to help you manage the recommendations made during your CMR.

Click here if you would like to schedule a CMR.

For a more detailed explanation of a CMR, click here.

What is a Targeted Intervention Program?

Targeted Intervention Program (TIPS) is patient specific program that identifies potential drug therapy problems. The pharmacist will work with the patient and his/her physician to determine the most appropriate action to take. TIPs will work toward providing more cost effective therapy choices for the patient as well as addressing safety, adherence, and proper therapeutic treatment issues for the patient. PrimeTime Health Plan will work with your pharmacist to identify any such issues for you.

Questions?

For more information about the MTM program, please contact PrimeTime Health Plan Service Center at 330-363-7407 or 1-800-577-5084 or, for TTY users, 1-800-617-7446, Monday through Friday, 8:00 a.m. to 8:00 p.m. (October 1st – February 14th, we are available 7 days a week, 8:00 a.m. to 8:00 p.m.).

Last updated: 09/30/2017