Medication Therapy Management

Eligible participants are those members with Medicare Part D prescription coverage who take at least 8 (eight) Part D drugs and are likely to incur or exceed annual costs of the CMS dictated threshold for all covered Part D drugs.

Participants of the program also have at least 3 (three) of the below mentioned chronic diseases/conditions:

• Alzheimer’s Disease
• Bone Disease ­Arthritis­ Osteoporosis
• Diabetes
• Dyslipidemia
• Hypertension

For more information about the MTM program, call member services at 1-888-477-0090 (TTY: 711).

Hours of Operation: 8am - 8pm, 7 days* a week
*October 1st - March 31st / Mon- Fri rest of the year

Once you are selected for the MTM Program, you will receive an eligibility notification letter and will be contacted to schedule a telephone consultation with a pharmacist. They will review your current prescriptions and over-the-counter medications and conduct an ongoing comprehensive medication review (CMR) to identify any potential medication related issues. If any medication issue is identified during the telephone consultation with a pharmacist, we will discuss it with your provider. Through this review, the pharmacist is able to identify and reduce the chance for medication errors; they will have more information about your current medication therapy, can help reduce duplicative therapy and offer affordable formulary alternative if applicable and it’s a great opportunity to identify and educate you on the side effects of the drugs you are taking and discuss ways to reduce those effects.

Upon completion of the CMR, an individualized written summary in the CMS standard format will be provided to you within 14 days of the CMR. The summary has a medication action plan that recommends what you can do to make the best use of your medications, with space for you to take notes or write down any follow-up questions. You will also get a personal medication list that will include all the medications you are taking and why you take them.

Download a blank copy of the Personal Medication List (pdf).

All MTM participants will receive follow-up mailings on a quarterly basis to remind them of their opportunity for the CMR and to provide general member education materials.

Participation in this program is voluntary. You are not required to participate in this program if you do not wish to do so. You can contact Elixir at 1-833-459-4424 (TTY: 711), 24 hours a day, 7 days a week to opt-out.

Last Updated on August 18, 2024