Eligibility & Services

Humana determines eligibility by looking at our members’ claims information.

The MTM program has different levels of participation. All eligible members receive a new MTM section in their SmartSummary Rx^SM. The section features tools to help members better manage and understand their medications, plus find lower-cost alternatives. Selected members are offered the opportunity to schedule a personal consultation.

Eligibility

Members must meet all three of the following requirements to be eligible for MTM. To stay eligible, members must meet these requirements each new plan year:

Have multiple chronic disease conditions
Fill a certain number of different Part D medications in a 90-day period
Have medication costs over $4,000 in a calendar year

Services

The MTM section in the SmartSummary Rx will show members how to get more from their medications while saving money.

The MTM section includes:

Rx Calculator – a comparative chart of your medications, including how much you spend
Drug Calendar – helps you remember what to take, how much, and when
Mail-Order Alternative – lists all prescriptions filled in the previous month and offers a mail-order form for lower-cost medications
A Request to Call – selected members will also receive a request to call and schedule a consultation

Call with questions

Phone: 1-888-686-4486

If you have a speech or hearing impairment and use a TTY: call 1-800-833-3301.

Representatives are available Monday through Friday, 8 a.m. – 8:30 p.m., Eastern time.

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