Medication Therapy Management Program 2025

Click here for 2024 Medication Therapy Management Program.

The Medication Therapy Management (MTM) program was developed by a team of pharmacists and doctors. This program helps eligible members use their coverage and 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.

How to Qualify

This program is available at no 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 $1,623 a year on covered Part D medications

are in a drug management program to help better manage and safely use medications such as opioids and benzodiazepines

You need to have three or more of these health conditions to qualify for the Medication Therapy Management program.

Alzheimer’s disease
Bone disease-arthritis (including osteoporosis, osteoarthritis, and rheumatoid arthritis)
Chronic congestive heart failure (CHF)
Diabetes
Dyslipidemia
End-stage renal disease (ESRD)
Human immunodeficiency virus/ acquired immunodeficiency syndrome (HIV/AIDS)
Hypertension
Mental health (including depression, schizophrenia, bipolar disorder, and other chronic/disabling mental health conditions) and
Respiratory disease (including asthma, chronic obstructive pulmonary disease (COPD), and other chronic lung disorders)

What You Need to Do

Within 60 days of becoming eligible for the MTM program, you'll receive an offer by mail to complete a Comprehensive Medication Review (CMR). You may also receive this offer by phone, email or text.

You can complete the CMR by phone. 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.

What’s Next

After completing a CMR, you'll receive a packet containing a summary of the review including action items discussed and a list of the medications you are taking and why you take them. This can be helpful when meeting with your doctor or pharmacist. The results may be sent to your doctor. In addition, you will receive information on the safe disposal of prescription medications including controlled substances.

You can also download a blank Personal Medication List (PDF) for your own personal use.

In addition to the CMR, Targeted Medication Reviews are done at least quarterly. This is done to find possible drug interactions or other medication concerns. Those reviews may be sent to your doctor for review.

MTM is not a benefit of your prescription drug plan, but a Medicare designed program offered at no cost by Preferred Care Network. For more information on Preferred Care Network’s Medication Therapy Management program, please call Member Services (the phone number is also on the back of your plan member ID card), or you may call the Optum Rx MTM clinical call center team at 866-216-0198 / TTY 711, Monday – Friday 9 a.m. – 9 p.m. EST.