Medication Therapy Management (MTM) Program
Memorial Hermann Advantage knows that prescription drugs play a vital role in keeping you healthy. Thus, we are excited to offer this free service to help you make sure your medications are working for you, help you find lower cost options, and answer any questions or concerns you may have about your medications. We are partnering with Outcomes to administer our Medication Therapy Management Program (MTM). This no-cost service helps you get the most from your prescriptions drug benefit by:
- Preventing or reducing drug-related risks
- Increasing your awareness about the medications you take
- Supporting good habits
- Providing information for safe medication-disposal options
How do you qualify for the MTM program?
- Have coverage limitation(s) in place for medication(s) with a high risk for dependence and/or abuse, or
- Meet the following criteria:
- Have a documented illness from at least three of the following chronic diseases:
- Alzheimer's Disease/Dementia
- Bone Disease-Arthritis (Including Osteoporosis, Osteoarthritis, and Rheumatoid Arthritis)
- Chronic and Disabling Mental Health Conditions (Including: Depression, Schizophrenia, and Bipolar Disorder)
- Chronic Heart Failure (CHF)
- Diabetes
- Dyslipidemia
- Human immunodeficiency virus /Acquired immunodeficiency syndrome (HIV/AIDS)
- Hypertension
- Respiratory Disease (Including asthma, chronic obstructive pulmonary disease (COPD), and other chronic lung disorders)
- Take eight or more Part D medications
- Have had an accumulated drug cost of at least $406 in the previous three months ($1,623 per year)
Your participation is voluntary and does not affect your coverage. The MTM program is available only to qualified Medicare Advantage members. Please note that not all plan members will qualify for the program, therefore the program is not considered a plan benefit.
What does the MTM program do?
The MTM program was developed by a team of pharmacists and doctors to assist members who may benefit from additional support with their Part D medications. We review your medications and health conditions to find ways to improve your health, lower risk of drug related problems, provide tips to help you take your medications and save money on your prescriptions. This review is done in the comfort of your home in just one phone call. These reviews include the following:
- Comprehensive Medication Review (CMR)
You may speak to a pharmacist regarding your medications, answer your questions and address you have about any medications you take including prescription drugs, over the counter (OTC) medications, herbal therapies, dietary supplements and/or vitamins. The review takes about 30 minutes and is usually offered once each year for qualified members. At the end of your discussion, the pharmacist will provide you with a Personal Medication List with the medications you discussed during your review.
You will also receive a Medication Action Plan. Your plan may include suggestions from the pharmacist for you and your doctor to discuss during your next doctor's visit.
- Targeted Medication Review (CMR)
During this review, a pharmacist will contact your doctor with suggestions about prescription drugs that may be safer or work better than your current drugs. As always, your prescribing doctor will decide what's best for you; your prescription drugs will not change unless you and your doctor decide to change them. A pharmacist may also contact you with suggestions about your medications.
Who provides the MTM services?
You may receive a call from a pharmacy where you recently filled one or more of your prescriptions. You will be given the option to choose an in-person review or a phone review.
You may be contacted by an Outcomes Patient Engagement Team call center pharmacist to provide your review, and ensure that you have access to the service if you want to participate. These reviews are conducted by phone.
You may also be contacted by a Memorial Hermann Health Plan Pharmacy Team member to coordinate and complete your medication review. These reviews are conducted by phone or as an in-person review when applicable. For more information or if you want to contact the Memorial Hermann Health Plan Pharmacy Team, please call (713) 424-3140 Monday to Friday from 9 a.m. to 5 p.m., CST.
Who do I contact for more questions?
If you take many medications for more than one chronic health condition contact your drug plan to see if you’re eligible for MTM, or for more information, please contact Outcomes Patient Engagement Team at: (855) 905-4689 (TTY 711) Monday through Friday, 8a.m. to 6 p.m. CST.
You may also call the plan to discuss about MTM services and request more information by calling Memorial Hermann Health Plan Pharmacy Team at (713) 424-3140 Monday to Friday from 9 a.m. to 5 p.m., CST.
How do I Opt Out of this program?
The MTM program aims to help you get the best benefits from your medications. Although we encourage members to take advantage of our valuable program, you do have the option to opt out of it. If you do not want to take part in the program, or if you have questions, please call Outcomes Patient Engagement Team at (855) 905-4689, Monday-Friday, 8 a.m. to 6 p.m. CST, For more detailed information, refer to Chapter 5 of your Evidence of Coverage.
How do I Opt Out of this program?
Medications that are safe for you may not be safe for someone else. Unneeded medications should be disposed of as soon as possible. You can discard your unneeded medications through a local safe disposal program or at home for some medications.
- Locating a community safe drug disposal site
A drug take back site is the best way to safely dispose of your medications. To find drug take back sites near you, visit the website below and enter your location:
U.S. Department of Justice controlled substance public disposal locations search
Some pharmacies and police stations offer on-site drop-off boxes, mail-back programs, and other ways for safe disposal. Call your pharmacy or local police department (non-emergency number) for disposal options near you.
- Mailing medications to accepting drug disposal sites
Medications may be mailed to authorized sites using approved packages. Information on mail-back sites can be found at www.deatakeback.com
- Safe at-home medication disposal
You can safely dispose of many medications through the trash. Visit the following website to learn more about safe at-home disposal: How to Safely Dispose of Drugs | HHS.gov