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Medicare Part D - Medication Therapy Management

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Medication Therapy Management

A female pharmacist sits with a senior female patient in the pharmacist consultation area and discusses her prescription and choice of medication. She is holding an a strip of the pills and chatting to the customer .In the background a female pharmacy assistant is checking orders at the counter .

Medication Therapy Management (MTM) Program

The Medication Therapy Management (MTM) Program is a free service for ConnectiCare Medicare plan members with a Part D prescription drug coverage who have certain health conditions and who take certain prescription medications covered by Medicare Part D. The MTM Program helps you and your doctor make sure that your medications are working to improve your health. It can also help prevent any issues with your medications.

If you qualify for the MTM Program, a pharmacist can review your prescription and over-the-counter medications and medical conditions. During the review, the pharmacist will talk to you about:

Better understanding your medications, how to take them, and any side effects or reactions
Possible ways to save money on your medications
Any questions or concerns you have

How do you sign up for the MTM Program?

To participate in the MTM Program, you must be eligible. If you qualify, we will automatically enroll you at no additional cost. We will mail you a letter and may follow up with a phone call and/or a text message inviting you to participate and providing information about the program. Participation is voluntary. You can opt out of the program at any time, but we hope you can take advantage of this opportunity to get the most from your medications.

There is no added cost for this program. While not considered a Medicare benefit, the MTM program is required by the Centers for Medicare and Medicaid Services (CMS) and is a special service part of your Medicare plan. The goal is to help you get the maximum benefit from your medications.

To find out more about the MTM Program, you can call ConnectiCare's Medicare Pharmacy Services toll-free at 888-447-0321 (TTY: 711), Monday to Friday, 9 a.m. to 5 p.m.

Who is eligible for the 2024 MTM Program?

To be eligible, you must meet the criteria of at least one of the following two groups (1) and/or (2).

You take eight or more prescription medications for ongoing conditions covered by Medicare Part D
You have at least three of the following conditions:
- Diabetes
- Chronic Heart Failure (CHF)
- Dyslipidemia (high cholesterol)
- Hypertension (high blood pressure)
- Osteoporosis
You must be likely to spend $5,330 or more in 2024 on prescription medications covered by Medicare Part D.

2. You are a good candidate for the Drug Management program based on the Centers for Medicare & Medicaid Services (CMS) guidelines.

Who is eligible for the 2023 MTM Program?

To be eligible, you must meet the criteria of at least one of the following two groups (1) and/or (2).

You take eight or more prescription medications for ongoing conditions covered by Medicare Part D
You have at least three of the following conditions:
- Diabetes
- Chronic Heart Failure (CHF)
- Dyslipidemia (high cholesterol)
- Hypertension (high blood pressure)
- Osteoporosis
You must be likely to spend $4,935 or more in 2023 on prescription medications covered by Medicare Part D.

2. You are a good candidate for the Drug Management program based on the Centers for Medicare & Medicaid Services (CMS) guidelines.

What will you get if you are eligible to participate in the program?

You will:

Receive a welcome letter in the mail and may receive a phone call and/or text message from us with information on how to get started.
Be invited to complete a full medication review with an ConnectiCare clinical pharmacist over the phone. During this review, the pharmacist will go over your medications including prescriptions, over-the-counter drugs, herbal therapies, and dietary supplements to make sure they are safe and working for you. The review may take up to 15-20 minutes.
Receive a personal medication list and medication action plan in the mail. Your personal medication list will help you keep track of your medications and how to use them the right way. Your medication action plan will have steps to help you get results from your medications. Be sure to share this information with your doctor.
Your medications can be reviewed every four months via a targeted medication review. After each review, we may send your doctor a letter explaining any issues or ways to improve. Your prescriptions will not change unless you and your doctor decide to change them.
Get helpful information on how to safely dispose of prescription drugs that are controlled substances, including opioids, at home and through takeback programs.

You and your health care providers can also keep track of the medications you are taking with a blank personal medication list.

We want to be sure you understand your medications and how to take them. We will answer any questions or concerns you may have.

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We're Here for You

If not currently enrolled call 877-224-8221 (TTY: 711)

From Oct. 1 to March 31, you can call us seven days a week from 8 a.m. to 8 p.m. From April 1 to Sept. 30, you can call us Monday through Friday from 8 a.m. to 8 p.m.

Medicare members call 800-224-2273 (TTY: 711)

From Oct. 1 to March 31, you can call us seven days a week from 8 a.m. to 8 p.m. From April 1 to Sept. 30, you can call us Monday through Saturday from 8 a.m. to 8 p.m.

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Last Update 10/01/2023

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Any information provided on this Website is for informational purposes only. It is not medical advice and should not be substituted for regular consultation with your health care provider. If you have any concerns about your health, please contact your health care provider's office. Also, this information is not intended to imply that services or treatments described in the information are covered benefits under your plan. Please refer to your Membership Agreement, Certificate of Coverage, Benefit Summary, or other plan documents for specific information about your benefits coverage.