Medication Therapy Management

A Medication Therapy Management (MTM) program is a service we offer at no cost. This program is not a benefit. The program is designed to ensure covered Part D drugs prescribed are appropriate to improve your medication use. The program will reduce the risk of adverse events like drug interactions.

If you qualify for this program, we will invite you to participate. You may decide not to participate, but it is recommended you take full advantage of this covered service.

Who Is Eligible?

Members must meet all of the following criteria for enrollment in the MTM program:

  1. Have at least three of the following multiple chronic diseases:
    • Acid reflux/ulcers
    • Alzheimer’s disease
    • Anemia
    • Anticoagulation
    • Atrial fibrillation
    • Benign prostatic hyperplasia (BPH)
    • Cerebrovascular disease
    • Chronic alcohol and other drug dependence
    • Chronic heart failure (CHF)
    • Chronic non-cancer pain
    • Diabetes
    • Dyslipidemia
    • End-stage renal disease (ESRD)
    • HIV/AIDS
    • Hypertension
    • Parkinson’s disease
    • Respiratory disease (such as asthma, chronic obstructive pulmonary disease (COPD) or chronic lung disorders)
    • Bone disease (such as osteoporosis, osteoarthritis or rheumatoid arthritis)
    • Mental health (such as depression, schizophrenia, bipolar disorder or chronic and disabling disorders)
  2. Taking four or more Part D covered drugs.
  3. Must spend more than $4,044 a year on Part D covered medications.

If you are eligible, CareSource will automatically enroll you into the program and we will notify you via letter.

You may opt out by calling our Member Services department at 1-844-607-2827 (TTY: 1-800-750-0750 or 711). We are open 8 a.m. to 8 p.m. EST, seven days a week from October 1 to February 14, and Monday through Friday the rest of the year.

What Does MTM Provide?

  • Annual Comprehensive Medication Review (CMR)
    This review is a one-on-one consultation with a CareSource pharmacist. During the review, your entire medication profile is reviewed to ensure appropriate therapy. Goals of the medication therapy and any problems are confidentially discussed. After the review, you will receive a completed Personal Medication List and Medication Action Plan by mail.
  • Quarterly targeted medication reviews
  • Follow-up interventions as necessary

How Does the Program Work?

  • First, you will qualify for the program.
  • Then, you will meet with an MTM pharmacist. Our Member Services department can help you find a pharmacy close to you.
  • Your MTM pharmacist will go over your medicines with you at your first visit. This is called a Comprehensive Medication Review (CMR). This will take approximately 45 minutes to one hour to complete.
  • Your MTM pharmacist will also give you a Standardized Takeaway Form that includes information about your Medication Action Plan.
  • The Standardized Takeaway Form includes a Personal Medication List. This lists all of your medicines and how you should take them.
  • Your MTM pharmacist may find problems with your medicines. For example, you might be taking more than one drug that does the same thing. Or you might not be taking enough of one medicine, or too much of another medicine.
  • Your pharmacist will talk with you and your doctor to fix any problems that come up during the CMR.

For more information on the MTM program, please call Member Services at 1-844-607-2827 (TTY: 1-800-750-0750 or 711). We are open 8 a.m. to 8 p.m. EST, seven days a week from October 1 to March 31, and Monday through Friday the rest of the year. 

Member Services: 1-844-607-2827 (TTY: 1-800-750-0750 or 711). We are open 8 a.m. to 8 p.m. EST, seven days a week from October 1 to March 31, and Monday through Friday the rest of the year.

CareSource is an HMO with a Medicare contract. Enrollment in CareSource Advantage® Zero Premium (HMO), CareSource Advantage® (HMO) and CareSource Advantage Plus® (HMO) depends on contract renewal.

 

This information is not a complete description of benefits. Call 1-844-607-2827 (TTY: 1-800-750-0750 or 711) for more information.

 

The Formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary.

   


Y0119_OHMA-M-0423_C
Updated 12/31/2018
CMS Accepted