Medication Therapy Management Program (MTMP)
Trillium Medicare Advantage has programs that help members manage their Part D and other medications in special situations. For example, some members have several complex medical conditions at one time. These members may need to take many drugs at the same time, or they could have high drug costs. A team of pharmacists and doctors developed a program for us to help these members with their care. This program is called the Medication Therapy Management Program, or MTMP.
The MTMP can help make sure that our members are using the drugs that work best to treat their medical conditions, help us to identify possible medication errors, and help improve medication adherence. The program is not considered a benefit and is voluntary and free to eligible members.
Members who are eligible for the MTMP have:
- Three or more of the following chronic disease states:
- Chronic Obstructive Pulmonary Disease (COPD)
- End Stage Renal Disease (ESRD)
- Mental Health-Depression
- Eight or more chronic or maintenance Part D medications
- Most likely have higher drug costs (more than $3,967 each year)
If you meet the criteria for the MTMP, we will automatically enroll you in the program. An MTM pharmacist reviews your medication history and sends you a welcome letter indicating you have qualified for MTMP. The letter describes any potential medication related problems found during their review and invites you to call for a medication review with an MTM pharmacist. If you decide not to participate, please notify us and we will withdraw your participation in the program.
The pharmacist or pharmacy intern under the direct supervision of a pharmacist will provide the following MTMP services with a final goal of helping the member reach the best therapeutic results to fit their needs:
- An annual Comprehensive Medication Review (CMR) is conducted either by phone or a face-to-face meeting to provide a collection of all the member’s medication related information and address any medication concerns. The CMR will take approximately 45 minutes.
- A Personal Medication List (PML) to record all prescription and over-the-counter medications which can be updated as needed (sample PML)
- A Medication Action Plan (MAP) made specific for the member after counseling to help them follow steps while taking medications to reach their health goals
- The PML and MAP are printed and either mailed or hand delivered within 14 calendar days of the Comprehensive Medication Review
- Quarterly Targeted Medication Reviews (TMR) which identify potential safety concerns, such as drugs which are not recommended for use in those over age 65, or any drug therapies that the member should be on, but are not, based on their conditions. If issues are identified, a letter is sent to the member and includes ways to help improve medication use. Additionally, a fax communication may be sent to the prescriber.
If the member is unable to participate, an authorized individual may participate on the member’s behalf. In addition, the pharmacist may work with other clinical team members if more services are needed in order to help the member reach their health goals.
If you have questions about the MTMP or want to learn more about our program, call us. We are here to help!
The Medication Therapy Management (MTM) Program helps you and your doctor make your medications work best for you and your condition. The benefits include improved use of medications and reduced risk of side effects. These benefits can lead to better health and quality of life. Please note this is a free service for eligible beneficiaries and it is not considered a benefit.
Who is Eligible?
To be eligible for this program, you must have all of the following:
- You have been told that you have three or more of the following conditions:
- Bone disease such as osteoporosis
- Bone disease such as arthritis
- Rheumatoid arthritis
- Chronic Heart Failure
- High blood pressure or hypertension
- High cholesterol or dyslipidemia
- Lung disease or asthma
- Lung disease or COPD (chronic obstructive pulmonary disease)
- Acquired immunodeficiency syndrome
- You take eight or more chronic drugs each month to treat your conditions.
- Your drugs will cost more than $3,919 during the plan year.
If you meet the criteria for the MTMP, we will automatically enroll you in the program. We will send you an offer letter indicating you have qualified for MTMP and invite you complete a medication review with an MTM pharmacist. If you choose, you may tell us at any time that you do not want to participate in the MTM program. We will continue to review your medications and may still contact your doctor directly to discuss any medication related concerns.
Trillium Medicare Advantage offers many services to qualified members. A pharmacist or pharmacy intern under the direct supervision of a pharmacist provides these services at no cost to you. Members may receive these services over the phone or in-person.
These services include the following:
- Comprehensive Medication Review (CMR) which provides time for a collection of all the member’s medication related information and address any medication concerns. The CMR will take approximately 45 minutes.
- A personalized written summary of the CMR delivered directly to you in-person or via mail within 14 days. This includes a Medication Action Plan (MAP) made specific to you after counseling with the pharmacist to help follow steps while taking medication to reach your health goals. Additionally, a Personal Medication List (PML) is included to record all prescription and over the counter medications which can be updated as needed (click here for sample PML).
- Continued monitoring of your medication therapy at least quarterly to help identify potential safety concerns such as medications which are not recommended in those over age 65 or any drug therapy you should be on, but are not based on your conditions
- Phone consultation or written communication with your doctor or other prescriber, if needed
- Translation into your language
If a member is unable to participate due to cognitive impairment, an authorized individual may participate on the member’s behalf. In addition, the pharmacist may work with other clinical team members if more services are needed in order to help the member reach their goals.
To learn more or get additional information, you may call Member Services at the phone number at the bottom of this webpage.
Last Updated: 09/30/2017