Medication Therapy Management

Medication Therapy Management Program (MTM Program)

The Generations Advantage Medication Therapy Management (MTM) program helps you get the greatest health benefit from your medications by:

  • Preventing or reducing drug-related risks
  • Increasing your awareness
  • Supporting good habits

Who qualifies for the MTM program?
Your participation is voluntary, and does not affect your coverage. This program is free of charge and is open only to those who qualify. The MTM program is not considered a benefit for all members.
We will automatically enroll you in the Generations Advantage Medication Therapy Management Program at no cost to you if all three (3) conditions apply:

  1. You take eight or more Medicare Part D covered maintenance drugs,
    and
  2. You have three or more of these long-term health conditions:
    • Asthma;
    • Chronic Heart Failure (CHF);
    • Diabetes;
    • Cardiovascular Disorders (such as high blood pressure, high cholesterol, or coronary artery disease);
    • Chronic Obstructive Pulmonary Disease (COPD);
    • Osteoporosis
    • Depression
    and
  3. For 2018 you reach $3,967 in yearly prescription drug costs paid by you and the plan.
    For 2019 you reach $4,044 in yearly prescription drug costs paid by you and the plan.

What services are included in the MTM program?
The MTM program provides you with:

  • Comprehensive Medication Review (CMR), and a
  • Targeted Medication Reviews (TMR)

Comprehensive Medication Review (CMR)
A CMR is a one-on-one discussion with a pharmacist to answer questions and address concerns you have about the medications you take, including:

  • Prescription drugs
  • Over-the-counter (OTC) medicines
  • Herbal therapies
  • Dietary supplements and vitamins
The pharmacist will offer ways to manage your conditions with the drugs you take. If more information is needed, the pharmacist may contact your prescribing doctor. A CMR review takes about 30 minutes and is usually offered once each year if you qualify. At the end of your discussion, the pharmacist will give you a Personal Medication List of the medications you discussed during your CMR.

You will also receive a Medication Action Plan. Your plan may include suggestions from the pharmacist for you and your doctor to discuss during your next doctor visit.

Here is a blank copy of the Personal Medication List for tracking your prescriptions.

Here is a copy of the complete Medication Therapy Management Program Standardized Format.

Targeted Medication Review (TMR)
With this review, we mail, fax or call your doctor with suggestions about prescription drugs that may be safer, or work better than your current drugs. As always, your prescribing doctor will decide whether to consider our suggestions. Your prescription drugs will not change unless you and your doctor decide to change them. We may also contact you, by mail or phone, with suggestions about your medications.

How will I know if I qualify for the MTM program?
If you qualify, we will mail you a letter. Also, you may receive a call, inviting you to participate in this one-on-one medication review.  

Will the MTM program pharmacist be calling from my regular pharmacy?
You may receive a call from a pharmacy where you recently filled one or more of your prescriptions. You will be given the option to choose an in-person review or a phone review.

You may be contacted by a call center pharmacist to provide your review, and ensure that you have access to the service if you want to participate. These reviews are conducted by phone.

Why is a review with a pharmacist important?
Different doctors may write prescriptions for you without knowing all the prescription drugs and/or over-the-counter (OTC) medications you take. For that reason, a pharmacist will:

  • Discuss how your prescription drugs and OTC medications may affect each other.
  • Identify any prescription drugs and OTC medications that may cause side effects, and offer suggestions to help.
  • Help you get the most benefit from all of your prescription drugs and OTC medications.
  • Review opportunities to help you reduce your prescription drug costs.

How do I benefit from talking with a pharmacist?

  • Discussing your medications can provide peace of mind knowing that you are taking your prescription drugs and OTC medications safely.
  • The pharmacy can look for ways to help you save money on your out-of-pocket prescription drug costs.
  • You benefit by having a Personal Medication List to keep and share with your doctors and health care providers.

How can I get more information about the MTM program?
For more information, please call the Martin's Point Generations Advantage Part D customer care center at 1-888-296-6961 or Martin's Point Generations Advantage Member Services at 1-866-544-7504, (TTY: 711), 8 am-8 pm, seven days a week from October 1 through March 31, and 8 am-8 pm, Monday through Friday the rest of the year.

Have Questions? Call Us!