What is the Medication Therapy Management program?

One-on-one review with a pharmacist or other trained health care provider.

Medication Therapy Management (MTM) is a Medicare designed program sponsored by Humana’s RxMentor program.

By participating in the program we want to help you get the best results from all of the medications you're taking. When you talk to a trained provider they can help you make sure your medications are working for you, may help you find lower cost options, and answer any questions you may have about your medications.

If you're like many of Humana's members, you're taking multiple medicines prescribed by more than one doctor. You could also be taking medicines that, when combined, may:

  • Reduce the effectiveness of your medicines
  • Cause severe side effects
  • Cost you more money per month

As part of your Medicare Part D coverage with Humana, you can set up a one-on-one review of your medicines with a pharmacist. This review is called a comprehensive medication review (CMR) and is offered at no extra cost to you. Once enrolled in the program, you or your prescriber may be contacted about a targeted medication review (TMR) if a pharmacist identifies an issue that needs attention after the CMR. If the MTM provider finds and issue during a CMR or a TMR that requires your prescriber's attention they may receive a telephone call or a fax from the MTM provider.

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:
    • 2020 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 $4,255 for 2020

How am I notified of my MTM eligibility?

Once eligible, you will be auto-enrolled and will receive notification within 60 days inviting you participate in the program.2

Once enrolled, you can visit any participating pharmacy for an in-person consultation or call Humana directly to be put in touch with a MTM Provider who can perform your consultation over the phone.

You may also call us at 1-888-686-4486 (TTY: 711). Representatives are available Monday through Friday, 8 a.m. to 7 p.m. EST. Although the MTM program is a special service offered at no cost to Medicare members, it is not considered a benefit.

Humana also works with other health organizations to provide MTM services on our behalf and one of these organizations may contact you about completing a Comprehensive Medication Review or other MTM services.

Partner organizations: Aspen RxHealth; Patient Engagement Team- OutcomesMTM; CHC Health; MedWatchers, Enhanced Medication Services.

As part of your consultation, the pharmacist will:

  • Go over the medicines you are currently taking
  • Make sure your medicines are safe for you
  • Answer any questions you may have about your medicines
  • Discuss possible lower-cost alternatives for your medicines
  • Discuss any concerns you have about your medicines
  • Work with you on ways to keep track of your medicines
  • Send you a summary of your consultation that includes the Personal Medication List, which is a list of all the medications you're taking, and a Medication Action Plan, which includes things that you talked about with the MTM provider.

Each consultation takes about 15 minutes to complete but can range from about 10 to 30 minutes.

Medication Therapy Management (MTM), is not part of a prescription drug benefit but is a CMS designed program.

For your convenience, a blank medication list may be printed by clicking the attachment below. Please use the form to keep track of all your prescriptions and over-the-counter medications.

Printable Personal Medication List

PERSONAL MEDICATION LIST – ENGLISH (63 KB)

PERSONAL MEDICATION LIST – SPANISH (65 KB)

  1. Program eligibility is dependent upon your membership contract.
  2. You will be automatically enrolled in our Medication Therapy Management (MTM) program based on your specific medications and medical history. Participation is voluntary. You can opt out of the MTM program or its services at any time by calling 1-877-801-0525.