2019 Medication Therapy Management (MTM) Program
The HMSA Medicare 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 understanding of the medications
- Supporting good habits
Here’s more information about the Medication Therapy Management program requirements.
Who qualifies for the MTM program?
We’ll automatically enroll you in the HMSA Medicare Advantage Medication Therapy Management program at no cost to you if these three conditions apply:
- You take eight or more Medicare Part D covered maintenance drugs
You have three or more of these long-term health conditions:
- Chronic obstructive pulmonary disorder (COPD)
- Chronic heart failure
- Cardiovascular disorders, such as high blood pressure, high cholesterol, or coronary artery disease
- You reach $4,044 in yearly prescription drug costs paid by you and the plan.
Your participation is voluntary, and doesn’t affect your health plan benefits. This program is free of charge and is open only to those who are invited to participate. The MTM program isn’t a benefit for all members.
What services are included in the MTM program?
The MTM program provides you with a:
- Comprehensive Medication Review (CMR)
- Targeted Medication Review (TMR)
Comprehensive Medication Review (CMR)
If you qualify for a CMR, you’ll speak to a pharmacist to ask questions and address concerns you have about your medications, 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 doctor. A CMR review takes about 30 minutes and is usually offered once each year. At the end of your discussion, the pharmacist will give you a Personal Medication List of the medications you discussed during your CMR.
You’ll also receive a Medication Action Plan. Your plan may include suggestions from the pharmacist for you and your doctor to discuss at your next visit.
Here’s a blank copy of the Personal Medication List for tracking your prescriptions.
Targeted Medication Review (TMR)
We’ll send suggestions to your doctor every three months about prescription drugs that may be safer or work better than your current drugs. As always, your doctor will decide whether to consider our suggestions. Your prescription drugs won’t change unless you and your doctor decide to change them.
How will I know if I qualify for the MTM program?
If you qualify, we’ll send you a letter to let you know. Later, you may receive a call from SinfoniaRx inviting you to schedule a one-on-one medication review on another day at a convenient time.
Will the MTM program pharmacist call from my regular pharmacy?
No. The MTM program pharmacist will be an employee of SinfoniaRx. You’ll receive calls from “HMSA” at an 808 area code phone number Monday through Friday, 8 a.m. to 3 p.m., and Saturday 8 a.m. to 12 p.m. Hawaii time.
Why is it important to review my medications with a pharmacist?
Different doctors may write prescriptions for you without knowing all the prescription drugs and over-the-counter (OTC) medications you take. For that reason, a pharmacist will:
- Discuss how your prescription drugs and OTC medications may interact with each other and affect you.
- 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.
- Look at ways to help you lower your prescription drug costs.
How will talking with a pharmacist benefit me?
- Talking to a pharmacist about how to take your prescription drugs and over-the-counter medications safely can give you peace of mind.
- The pharmacist can suggest ways for you to save money on your out-of-pocket prescription drug costs.
- You’ll have a personal medication list to keep for your records and share with your doctors and other health care providers if necessary.