Medication Therapy Management program
UnitedHealthcare’s 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, by providing members with a comprehensive medication review (CMR) with a pharmacist or other qualified health care provider. It can also help protect members from the possible risks of drug side effects and potentially harmful drug combinations.
- How to qualify
- What you need to do
- What's next
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
OR
- 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) (253 KB) for your 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 UnitedHealthcare. For more information on UnitedHealthcare's Medication Therapy Management program, please call the number 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, 9a.m. to 9p.m. ET Monday through Friday.
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