Medication Therapy Management

We can help you stay healthy with the Medication Therapy Management (MTM) Program. It is also known as the Medicine Review Program. The program gives you the tools you need to get the most from your medicines. We offer the MTM Program to members of OneCare (HMO SNP) at no cost.

We choose members who are at the highest risk for medicine problems to be in MTM. The program offers you a pharmacist to talk to at no cost. Our MTM trained pharmacists teach you how to take your medicine in a safe and proper way. Taking your medicine, the correct way helps prevent side effects from your medicine. It can also lower your out-of-pocket costs.

As part of the MTM Program, a pharmacist does a comprehensive medication review (CMR) with you. We can do the CMR with you in person or over the phone. Your CMR may take 30 to 60 minutes to complete.

During your CMR, the pharmacist looks at:

After meeting with a pharmacist, we will mail you 2 documents:

Pharmacists performs targeted medication reviews (TMR) at least once each quarter. The pharmacist looks at only some of the medicines you take to see if there are problems that could put you at risk. If you are at risk, the pharmacist will tell your doctor.

Once a quarter, we select members to take part in the MTM program. If chosen, we will mail you a letter to let you know.

You are chosen for MTM if A, B and C apply to you:
A. You receive medicines for 3 or more of the following conditions:

B. You are taking 8 or more medicines through OneCare per quarter

C. You will likely exceed $4,255 in medicine costs per year

You may also be eligible for the MTM Program if 1 or 2 apply to you:

You filled opioid medicines at high average doses in the past 6 months; and

1. The opioid prescriptions were written by 3 or more prescribers and filled at 3 or more pharmacies or

2. The opioid prescriptions were written by 5 or more prescribers

If you do not wish to be part of this program, to opt out please call OneCare Customer Service at 1-877-412-2734, 24 hours a day, 7 days a week. We have staff who speak your language. TDD/TTY users can call toll-free at 1-800-735-2929.

Read the letter mailed to you once a quarter. It also includes an update about different health topics.