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:

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:

  1. You take eight or more Medicare Part D covered maintenance drugs
  2. You have three or more of these long-term health conditions:
    • Asthma
    • Chronic obstructive pulmonary disorder (COPD)
    • Diabetes
    • Depression
    • Osteoporosis
    • Chronic heart failure
    • Cardiovascular disorders, such as high blood pressure, high cholesterol, or coronary artery disease
  3. 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)

If you qualify for a CMR, you’ll speak to a pharmacist to ask questions and address concerns you have about your medications, including:

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:

How will talking with a pharmacist benefit me?

How can I get more information about the Medication Therapy Management (MTM) program?

To find out more about MTM, call SinfoniaRx at 1-855-608-4808, Monday through Friday, 4 a.m. – 3 p.m. Hawaii time. For TTY, call 711.