Who’s eligible for MTM
Humana determines eligibility by looking at our members’ medication claims information. 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 $3,000 in a calendar year
MTM services
The MTM program has different levels of participation.
All eligible members get an MTM introductory section in SmartSummary Rx®. Your SmartSummary Rx® may include a request to call and schedule a consultation. If you get this notice, please call MTM; it's important to your health.
Selected members who have a higher risk level for harmful drug reactions are offered the opportunity to schedule a personal consultation at no additional cost. This consultation with a pharmacist can be on the phone or face-to-face at a local pharmacy. As part of your consultation, the pharmacist will:
- Answer questions you have about your medications
- Evaluate how and when to take your medications
- Discuss any areas of concern about your medications or offer lower-cost alternatives to the drugs you take
- Contact your doctor(s) with recommendations after the consultation if needed
You're encouraged to discuss any issues that the MTM program reveals with your doctor(s). Humana also will contact your doctor if we are concerned about your safety. Humana's MTM program is intended to be a health resource added to your doctor's treatment plan. It's in no way intended to interfere with, or replace, that plan.
Call with questions
Phone: 1-888-686-4486
If you use a TTY: 1-800-833-3301
Representatives are available Monday through Friday, 9 a.m. – 9 p.m., Eastern time.
