UnitedHealthcare's Medication Therapy Management (MTM) program was developed by a team of pharmacists and doctors. This program helps eligible members use their coverage, understand their medications, and how to use those medications. It can also help protect members from the possible risks of drug side effects and potentially harmful drug combinations.
This program is available at no additional cost. You'll be automatically enrolled in the Medication Therapy Management program if you:
- take eight (8) or more chronic Part D medications, and
- have three (3) or more long-term health conditions, and
- are likely to spend more than $4,044 a year on covered Part D medications in 2019 or $4,255 in 2020
You need to have three or more of these health conditions to qualify for the Medication Therapy Management program.
- Hypertension (High Blood Pressure)
- Heart Failure
- High Cholesterol
- Rheumatoid Arthritis
Within 60 days of becoming eligible, you'll receive an offer by mail to complete a Comprehensive Medication Review (CMR). You may also receive this offer by phone.
You can complete the CMR by phone or in person with a qualified health care provider. It takes about 30 minutes. A pharmacist, or qualified CMR provider, will review your medication history, including prescription and over-the-counter medications, and look for any issues.
Within 14 days of the CMR, you'll receive a Medication Action Plan. It summarizes any clinical concerns and a Personal Medication List of your medication history. This can be helpful when meeting with your doctor or pharmacist. In addition, the results may be sent to your doctor.
In addition to the CMR, Targeted Medication Reviews are done at least quarterly. This is done to find any drug-drug interactions or other medication concerns. Those reviews will be sent to your doctor.
The Medication Therapy Management program isn't a plan benefit. For more information on UnitedHealthcare's Medication Therapy Management program, please call the phone number on the back of your plan member ID card.