Medication Therapy Management

About the Medication Therapy Management (MTM) or Medicine Review Program

The Medication Therapy Management (MTM) Program, also known as the Medicine Review Program, can help you stay healthy. The program gives you the tools you need to get the most from your medicines. We offer the MTM Program to members of OneCare Connect Cal MediConnect Plan (Medicare-Medicaid Plan) at no cost.

We choose members who are at the highest risk for medicine problems to participate in this program. The MTM program offers a pharmacist consultation 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 drug side effects and can lower your out-of-pocket costs.

Comprehensive Medicine Review

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.

During your CMR, the pharmacist looks at:

  • Why you are taking each of your medicines
  • If the medicines you are using are working for you
  • If your medicines are causing any side effects or making you sicker
  • If your medicines effect each other, foods or over-the-counter medicines
  • If there are ways to lower the number of medicines you are taking

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

  • Medication Action Plan (MAP): This document shows you steps you can take to get the most out of your medicines.
  • Personal Medication List (PML): This document lists all your medicines, how you take them and why you take them.

You may download a blank PML to track other medicines or update your list.

Also as part of the MTM program, a pharmacist performs targeted medication reviews (TMR) at least once each quarter. During the TMR, the pharmacist looks at only some of the medicines you take to see if there are problems that could put you at risk. If the pharmacist finds that you are at risk for medicine problems, the pharmacist tells your doctor.

MTM Eligibility Requirement

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

You are chosen for MTM if all of these apply to you:

  • You receive medicines for 3 or more of the following conditions:
    — Diabetes
    — Asthma
    — Chronic Obstructive Pulmonary Disease (COPD)
    — Hypertension or high blood pressure
    — Dyslipidemia or high cholesterol
    — End-Stage Renal Disease (ESRD)
  • You are taking 8 or more medicines through OneCare Connect per quarter
  • You will likely exceed $4,044 in medicine costs per year

If you do not wish to be entered in this program, please call OneCare Connect Customer Service to opt out.

To learn more about our MTM Program or to opt out, please call OneCare Connect toll-free at 1-855-705-8823. You can call 24 hours a day, 7 days a week. Or you can visit our office Monday through Friday, from 8 a.m. to 5 p.m. TDD/TYY users can call toll-free at 1-800-735-2929. We have staff who speak your language.

To file a complaint with Medicare, click on the following link to complete a complaint form on the Medicare website: Medicare Complaint Form.

H8016_19MM087 Accepted 1/21/19

OneCare Connect Cal MediConnect Plan (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Medi-Cal to provide benefits of both programs to enrollees. Limitations, co-pays, and restrictions may apply. For more information, call OneCare Connect Customer Service or read the OneCare Connect Member Handbook. Benefits and/or copayments may change on January 1 of each year. Copays for prescription drugs may vary based on the level of Extra Help you receive. Please contact the plan for more details. Other Pharmacies/Physicians/Providers are available in our network. The List of Covered Drugs and/or pharmacy and provider networks may change throughout the year. We will send you a notice before we make a change that affects you. OneCare Connect complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. You can get this information for free in other languages. Call toll-free 1-855-705-8823. TDD/TTY users can call 1-800-735-2929. The call is free.

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