Medication Therapy Management
75 wellbeing points
What is Medication Therapy Management?
Managing your medications can get increasingly complicated when you’re taking several of them. Medication Therapy Management (MTM) begins with a face-to-face meeting between you and a specially trained pharmacist. The pharmacist will complete a health assessment and will review all of your prescription, over-the-counter, and herbal medications to be sure they are safe and effective. The UPlan pays the full cost of MTM services so there is no copay or other cost to you for the consultations with the pharmacist.
Am I Eligible for MTM?
You and your enrolled dependents are eligible to participate in the MTM program if:
- You take four or more UPlan-covered prescriptions and over-the-counter medications for chronic conditions,
- You have diabetes, regardless of how many medications you take,
- You have a letter of referral for MTM services from your physician.
- Choose Your MTM Pharmacist
- What to Expect in Your First MTM Meeting
- For Medica HSA Members
- For Members with Diabetes
- How Do I Earn wellbeing points?
Pharmacists in the Directory of MTM Pharmacists have met credentialing standards developed by the UPlan showing that they have received education on delivering MTM services.
MTM pharmacists are based out of clinics or community pharmacies. You can see any of the MTM pharmacists in the directory. The clinic or pharmacy does not need to be your regular medical plan clinic or pharmacy where you have prescriptions filled.
For your first meeting, bring your Medica and Prime Therapeutics ID cards and all of your prescription and over-the-counter medication bottles or a complete list of your current prescriptions (including dosage and frequency), over-the-counter medications, herbal supplements, and vitamins. You can use My Medicine Record (pdf) to list your medications.
Your MTM meeting will be held in a private room in the pharmacy or the clinic where you will sit down one-on-one with your MTM pharmacist. The space will be large enough to accommodate at least three people without others being able to hear the MTM consultation and without distractions from other conversations in the facility. The pharmacist will ask you questions about your medical conditions, your medical history, and current and past medication use to check if there are any problems with your current medications.
With your permission, the pharmacist will contact your primary care provider and give their assessment and recommendation. Your pharmacist will work closely with your primary care provider to make your health care as effective as possible and fix any medication-related problems.
In the HSA plan, your deductible and coinsurance will apply, and you will pay the cost of the consultations and your prescription medications. You can choose to use your HSA account to cover some costs. The benefit for participating comes from the advice and helpful discussion with the MTM pharmacist to understand your medications better.
For members with diabetes, you can participate in the MTM program no matter how many medications you take, and the UPlan will pay the cost of the face-to-face consultations with the MTM pharmacist. By meeting privately with a specially trained pharmacist, you'll get the help you need to better understand your medications and improve your health. The pharmacist does a careful review of your medications, helps you set goals, and works directly with you and your physician on a regular basis to make sure that each medication is appropriate, safe, and effective.
You can also better manage your diabetes by participating in condition management or lifestyle management health coaching through the Wellbeing Program and earn more wellbeing points.
You can earn 25 wellbeing points per visit (75 max per year) for meeting with an MTM pharmacist three times or more between October 1, 2020, and August 31, 2021, and working with the pharmacist and your doctor to make appropriate changes in your medication therapy. Learn more about earning wellbeing points on the Wellbeing Program web page.
For more information on MTM, call 4-UOHR (612-624-8647 or 1-800-756-2363) and select option 1 or email firstname.lastname@example.org.