What is the Medication Therapy Management program?
Medication Therapy Management (MTM), while not a part of a prescription drug benefit, is a Medicare-designed program sponsored by Humana’s RxMentor program. If you’re taking multiple medicines prescribed by more than one doctor, these medicines, when combined, may:
- Cause severe side effects
- Cost you more money per month
- Reduce their efficacy
We want to help you get the best results from all of the medications you're taking. By participating in the program, you get to talk to a trained provider who can help you make sure your medications are working for you, find lower-cost options when available, and answer your questions.
As part of your Part D coverage with Humana, you can set up a one-on-one Comprehensive Medication Review (CMR) of your medicines with a pharmacist. This review is free.
If a pharmacist when completing your CMR identifies an issue, you or your provider may be contacted about a targeted medication review (TMR). After a TMR, if there still is an issue, your provider may be contacted, either by telephone or fax.
How you qualify for the program
Humana determines eligibility quarterly, by looking at your medication claims information. Once you qualify, you remain in the program for the rest of the calendar year. You will have to re-qualify for the next calendar year.1 In order to qualify for the MTM program, you must meet all three of the following criteria:
- Have three of the five following conditions:
- Chronic Heart Failure (CHF), Rheumatoid Arthritis, Diabetes, Dyslipidemia (Abnormal Cholesterol), or Asthma, AND
- Are taking eight or more chronic maintenance (Part D) drugs, AND
- Are likely to incur annual Part D Medication costs of $4,376 for 2021
How am I notified of my MTM eligibility?
Once deemed eligible, you will be auto-enrolled and will receive notification within 60 days.2 Once enrolled, you can visit any participating pharmacy for an in-person consultation. You also can call us at 1-888-686-4486 (TTY: 711), Monday – Friday, 8 a.m. – 7 p.m., Eastern time, to set up and have a telephone consultation.
Medication Therapy Management (MTM) is not part of a prescription drug benefit but is a CMS designed program.
Humana also works with other health organizations to provide MTM services on our behalf. These organizations include:
- Aspen RxHealth
- CHC Health
- MedWatchers, Enhanced Medication Services
- Patient Engagement Team – OutcomesMTM
One of these organizations may contact you about completing a CMR or other MTM service.
As part of your consultation, the pharmacist will:
- Answer your questions about your medicines
- Discuss possible lower-cost alternatives for your medicines
- Discuss your concerns about your medicines
- Make sure your medicines are safe for you
- Review the medicines you take
- Send you a consultation summary, including a Personal Medication List (e.g., a list of all the medicines you take), and a Medication Action Plan (e.g., a list of what you and the MTM provider discussed)
- Work with you on ways to keep track of your medicines
Each consultation takes about 15 minutes to complete but can range from about 10 to 30 minutes.
You can print a blank medication form below. Please use the form to keep track of your prescriptions and over-the-counter medicines.
Printable Personal Medication List
Personal Medication List – ENGLISH (63 KB)
Personal Medication List – SPANISH (65 KB)
- Program eligibility is dependent upon your membership contract.
- You will be automatically enrolled in our Medication Therapy Management (MTM) program based on your specific medicines and medical history. Participation is voluntary. You can opt out of the MTM program or its services at any time by calling 1-888-686-4486.
