Medication Therapy Management
What is Medication Therapy Management?
Managing your medications can get increasingly complex when you’re taking several of them. Medication Therapy Management (MTM) is a program that pays the full cost of a face-to-face consultation with a specially-trained pharmacist. During this private meeting you will discuss your medication goals, such as reducing the number or the cost of your prescriptions, or resolving medication-induced side effects.
Am I Eligible for MTM?
If you take four or more UPlan-covered prescriptions and over-the-counter medications for chronic conditions, you are eligible to participate in the MTM program. You can also qualify simply by having a referral from your physician.
Your enrolled dependents are also eligible to participate in MTM, provided they meet the requirements listed above.
UPlan members with diabetes are eligible regardless of how many medications they take.
Do I Get Wellness Points for MTM Participation?
Yes, you can earn 100 Wellness Points for meeting with MTM pharmacist three times or more between October 1, 2015, and August 31, 2016.
- Choose Your MTM Pharmacist
- What to Expect in Your First MTM Meeting
- For Medica HSA Members
- For Members with Diabetes
Pharmacists in the Directory of MTM Pharmacists have met credentialing standards developed by the UPlan showing that they have received education on the delivery of MTM.
MTM pharmacists are based out of clinics or community pharmacies. It is possible that the MTM pharmacist you choose will not be part of your regular clinic or pharmacy. However, there is no need for you to change your prescription medications or your clinic to the MTM provider's location.
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, over-the-counter medications, herbal supplements, and vitamins. You can use this form called My Medicine Record(pdf) to list your medications.
Your MTM consultation will be held in a private room in the pharmacy or the clinic where you will meet one-on-one with your MTM pharmacist. The pharmacist will ask you questions about your medical conditions, your medical history, and current and past medication use. This information will be used to assess your current medications and identify any problems with your medications.
With your permission, the pharmacist will contact your primary care provider and present an assessment and recommendation. Your pharmacist will work closely with your primary care provider to make your health care as effective as possible and resolve any medication-related problems.
In the HSA plan, the deductible and coinsurance will apply, and you will pay the cost of the consultations and your prescription medications. You may choose to use your HSA account to cover some costs. The benefit from participating comes from the helpful discussion with the MTM pharmacist and your increased understanding of your medications.
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 will get the help you need to better understand your medications and improve your health outcomes. The pharmacist does a thorough review of your medications, helps you set goals, and works directly with you and your physician on a regular basis to ensure that each medication is appropriate, safe, and effective.
Not only will you gain a better understanding of your medications, you can earn 100 Wellness Program points if you meet with the pharmacist at least three times by August 31, 2016. Make a further commitment to managing your diabetes by participating in condition management or lifestyle management health coaching through the Wellness Program and earn more wellness points.