Copy of the fact sheet with information about safe disposal of expired or unused drugs
Medication Therapy Management Program (MTM)
Optimize the use of your medications to obtain better therapeutic results.
The Medication Therapy Management Program (MTM) is designed to help eligible members with multiple conditions reconcile their medication profile and identify and resolve any drug related problems in order to optimize therapeutic outcomes. The Program is individualized, voluntary and complimentary to the drug coverage.
The benefits of the Program include a complete evaluation of the drug therapy to ensure adequate and safe use of medications. This assessment consists of education and recommendations to the member, as well as for the physician or other health care professionals at no additional cost to the member.
This program is not considered a benefit of the drug coverage. However, it is offered at no additional cost to the member.
Eligibility Criteria for MMM Healthcare, LLC's MTM Program.
Members will automatically enter the program if they comply with the requisites of at least one of the following two groups, according to the criteria established by the Centers for Medicare and Medicaid Services (CMS):
1. Members who meet the following three (3) criteria:
- Have accumulated prescription drug costs under Part D (including plan and member payments) totaling $319.00 over the last three (3) months or $1,276.00 during the last twelve (12) months.
- Present at least three (3) chronic conditions from the following list:
- Diabetes (DM)
- Dyslipidemia
- Hypertension (HTN)
- Chronic Heart Failure (CHF)
- End-Stage Renal Disease (ESRD)
- Alzheimer’s Disease
- Bone Arthritis Disease (including osteoporosis, osteoarthritis, and rheumatoid arthritis)
- Human Immunodeficiency Virus (HIV)/Acquired Immunodeficiency Syndrome (AIDS)
- Mental Illness (depression, schizophrenia, bipolar disorder, and chronic/disabling mental health conditions)
- Respiratory Disease (asthma, chronic obstructive pulmonary disease (COPD), and chronic lung disorders)
- Use at least eight (8) medications covered under Medicare Part D, including all maintenance medications.
2. Members considered at risk of opioid overutilization with an active coverage limitation of any of these drugs under the Drug Management Program (DMP).
MTM Services and Materials
Members enrolled in the program will get the following:
Welcome Letter (through mail), explaining the program in detail. Also, written information about the safe disposal of expired medications or those no longer in use, including controlled substances such as opioids (a downloadable version of this information is available at the end of this page).
Annual comprehensive medication review (CMR) to identify potential drug therapy problems and create an action plan to resolve them. The evaluation takes 20 to 30 minutes, depending on the member.
During the comprehensive medication review with a qualified professional, the members will receive individualized education about their medication therapy and health conditions.
Follow up evaluations by a health care professional, including quarterly targeted medication reviews (TMR) such as monitoring of medication utilization.
Consultations and interventions with prescribing physicians and/or other health care professionals to optimize therapy and resolve any medication related issues.
Referrals to other company programs will be offered, if necessary.
After the evaluation, the member will receive a summary that includes an updated list of their medications, and the action plan defined for their medication therapy.
Download a copy of the fact sheet with information about safe disposal of expired or unused drugs.
- Copy of the Personal Medication List
- Members Rights and Responsibilities
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A Medicare Advantage plan that provides all the Original Medicare Part A and B coverage, and in certain cases includes Part D prescription drug coverage. In most HMOs, you can only get care from doctors or hospitals in the plan's network, except in emergencies.
A Medicare Advantage plan that provides focused, specialized health care for a specific group of people with special needs — for example, people who have both Medicare and Medicaid, people living in nursing homes, and people with certain chronic conditions.
A type of Medicare Advantage plan available in a local or regional area where you pay less if you use doctors, hospitals and providers in the network. You may use out-of-network providers for an additional cost.
The Centers for Medicare & Medicaid Services (CMS) require agents to document the scope of the marketing appointment before the in-person sales meeting, to ensure it is understood what will be discussed between the agent and the Medicare beneficiary (or their authorized representative). All information provided on this form is confidential and must be completed by each person who has Medicare or their authorized representative. By signing this form, you are accepting a sales appointment or a call from one of our sales representatives to discuss the specific products you selected above. The person who will discuss plan options with you is an employee of, or contracted by, a Medicare Health Plan that is not part of the Federal Government, and may be compensated based on your enrollment in a plan. This is not an enrollment request. Signing this form does NOT affect your current contract, nor will it enroll you in a Medicare Advantage or other Medicare plan.