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Medication Therapy Management Program 2025

The HMSA Medicare Advantage Medication Therapy Management Program (MTM) is all about you and your health. The MTM Program helps you get the most out of your medications by:

Who qualifies for the MTM Program?

You’ll be enrolled in the HMSA Medicare Advantage MTM Program if you meet one of the following:

  1. Have coverage limitation(s) in place for medication(s) with a high risk for dependence and/or abuse, or
  2. Meet the following criteria:
    • You have three or more of these conditions:
      • Alzheimer's disease.
      • Bone disease-arthritis, including osteoporosis, osteoarthritis, and rheumatoid arthritis.
      • Chronic congestive heart failure (CHF).
      • Diabetes.
      • Dyslipidemia.
      • End-stage renal disease (ESRD).
      • Human immunodeficiency virus/Acquired immunodeficiency syndrome (HIV/AIDS).
      • Hypertension.
      • Mental health, including depression, schizophrenia, bipolar disorder, and other chronic disabling mental health conditions.
      • Respiratory disease, including asthma, chronic obstructive pulmonary disease (COPD), and other chronic lung disorders.
    • You take eight or more maintenance medications covered by your plan.
    • You’re likely to spend more than $1,623 in prescription drug costs in 2025.

Your participation in the MTM Program is voluntary and doesn’t affect your coverage. This is not a plan benefit and is open only to those who qualify. There’s no extra cost to you for the MTM Program.

How will I know if I qualify for the MTM Program?

If you qualify, we’ll mail you a letter. We may also call you to set up your one-on-one medication review.

What services are included in the MTM Program?

In the MTM Program, you’ll receive the following services from a health care provider:

What's a comprehensive medication review?

The comprehensive medication review is a discussion with a health care provider in person or over the phone about your medications, including:

This review usually takes 20 minutes or less to complete. During the review, you can ask questions about your medications or health conditions. The health care provider may offer ways to help you manage your health and get the most out of your medications. If more information is needed, the health care provider may contact your prescriber.

At the end of the review, the health care provider will provide you with a summary of what you discussed. The summary will include a:

Here’s a blank copy of the Medication List [PDF] to track your medications.

Who'll contact me about completing the review?

You may receive a call from a pharmacy where you recently filled one or more of your prescriptions. You can choose to complete the review in person or over the phone.

A health care provider may also call you to complete your review over the phone. When they call, you can schedule your review at a time that’s convenient for you.

Trusted MTM Program partners: CVS Caremark Pharmacist Review Team, Outcomes Patient Engagement Team, MedWatchers, and Pack4U Connected Health.

Why is this review important?

Different prescribers may write prescriptions for you without knowing all the medications you take. For that reason, the MTM Program health care provider will:

How do I benefit from talking with a health care provider?

By completing the medication review with a health care provider, you’ll:

What's a targeted medication review?

The targeted medication review is completed by a health care provider who reviews your medications at least once every three months. With this review, we mail, fax, or call your prescriber with suggestions about prescription drugs that may be safer or work better for you. As always, your prescriber will decide whether to consider our suggestions. Your prescription drugs will not change unless you and your prescriber decide to change them. We may also contact you by mail or phone with suggestions about your medications.

How can I get more information about the MTM Program?

For more information about the HMSA Medicare Advantage MTM Program or if you don’t want to participate, call us at 1-855-484-1580 Monday through Friday, 3 a.m. to 2 p.m. Hawaii time or Saturday, 4 a.m. to 8 a.m. Hawaii time. For TTY, call 711.

How do I safely dispose of medications I don’t need?

Medications that are safe for you may not be safe for someone else. Unneeded medications should be disposed of as soon as possible. You can discard your unneeded medications through a local safe disposal program or at home for some medications.