Medication Therapy Management

Medication Therapy Management (MTM) is a service we offer at no cost to you. This program is not a benefit. MTM is designed to help you understand the drugs you are taking. We want to make sure you are comfortable taking your medications and help you avoid any dangerous drug interactions.

If you are eligible for an annual Comprehensive Medication Review (CMR) as part of the MTM program, 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 1-855-475-3163 (TTY: 1-833-711-4711 or 711). We are open 8 a.m. to 8 p.m. Monday through Friday, and from October 1 through March 31 we are open the same hours, seven days a week.

What Does MTM Provide?

  • Annual Comprehensive Medication Review (CMR) for qualifying individuals.
    • This is a one-on-one consultation with either your local pharmacist, a CareSource pharmacist, or another qualified medical professional. 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

Who Can Be in the Program?

CareSource members who have chronic health conditions and take many drugs may qualify for the program. If you meet the qualifications below, you will get a letter in the mail letting you know that you are enrolled.

You will be enrolled in this program if you:

  • Take eight or more Medicare Part D covered maintenance drugs.
  • Have three or more long-term health conditions, such as diabetes, asthma or high blood pressure.
  • Spend more than $1,276 a year on Part D covered medications.

How Does MTM Work?

  • First, you will need to verify if you qualify for the program. CareSource will mail you a letter if you qualify for the MTM program.
  • Then, you will meet with an MTM pharmacist. A CareSource RxInnovations™ pharmacist 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 1 hour to complete.
  • Your MTM pharmacist may find opportunities to improve your drug list. For example, you might be taking more than one drug that does the same thing. Or you might not be taking enough of a drug, or too much of another drug.
  • Your MTM pharmacist will talk with you and contact your doctor to fix any problems that come up during the CMR.

For more information on the MTM program, please call our CareSource RxInnovations team at 1-833-230-2073 (TTY: 1-833-711-4711 or 711). We are open 9 a.m. to 5:30 p.m. EST Monday through Friday.

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