Medication Therapy Management Program (MTM)

Medication Therapy Management Program (MTM Program)
The Medication Therapy Management (MTM) is a voluntary program that helps you get the greatest health benefit from your medications by:

  • Preventing or reducing drug-related risks
  • Increasing your awareness
  • Supporting good habits

Who qualifies for the MTM Program?
You qualify for the program if:

  1. You take eight or more Medicare Part D covered maintenance drugs, and
  2. You have three or more of these long-term health conditions:

Asthma, COPD, Diabetes, Depression, Osteoporosis, Chronic Heart Failure, HIV or Cardiovascular Disorders such as High Blood Pressure, High Cholesterol or Coronary Artery Disease.

  1. You reach $3,919 in yearly prescription drug costs paid by you and the plan.

This program is free of charge and is open to those who qualify.  The MTM program is a clinical program provided by our Plan and is not considered a plan benefit.

What services are included in the MTM program?
The MTM Program provides you with a:

  1. You will receive at least one phone meeting with the clinical team to go through a review of your medications. You also get quarterly drug reviews. The phone meeting will take approximately 10 – 20 minutes to complete.
  2. A Care Team member gets the information to do a full drug review. This drug review does not hinder the care by your doctors. It may include looking at:

How your drugs interact
Ways to help reduce side effects
Lower cost alternate drugs
Simplifying your drug intake

  1. You will receive a summary of the review, including a list of suggestions from the pharmacist.

How will I know if I qualify for the Medication Therapy Management Program (MTM Program)?
If you qualify, you will receive a letter from Kalos Health Gold Plus.  This letter will explain the program and let you know that you are enrolled in the program. After you receive the letter, a member of the Medication Therapy Management team will contact you by phone, unless you call the number on the letter saying that you don’t want to participate (“opt out”).

How can I get more information about the Medication Therapy Management Program (MTM Program)?
Please contact us if you would like additional information about our MTM Program, or if you do not want to participate after being enrolled in the program.  Our toll free number is 1-800-399-1954 (TTY: 711), Monday – Friday 7:30am – 5pm.

Here is a blank copy of Medication Therapy Management Program (MTM)

Questions? Call our Member Services Department at 1-800-399-1954 (TTY: 711), Monday – Friday 8am – 8pm.