What is the Medication Therapy

What is the Medication Therapy Management program?

Medication Therapy Management (MTM), while not part of a prescription drug benefit, is a Medicare designed program sponsored by Humana's RxMentor program.

If you're like many of Humana's Medicare 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 may be contacted about a targeted medication review (TMR) if a pharmacist identifies an issue that needs attention after the CMR.

How you qualify for the program

Humana determines eligibility monthly, 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. 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), Hypertension (High Blood Pressure), Dyslipidemia (Abnormal Cholesterol), Osteoporosis, or Diabetes, AND
  • Are taking eight or more chronic maintenance (Part D) drugs in a 30 day period, AND
  • Are likely to incur annual Part D Medication costs of $3,138.

How you are notified of your MTM eligibility

Once eligible, you will receive a letter within 60 days of your eligibility that invites you to either call the MTM call center or gives you the address and phone number of a local pharmacy to schedule a review. You may also call us at 1-888-686-4486. If you use TTY, call 711. Representatives are available Monday through Friday, 8 a.m. to 8 p.m. EST. Although the MTM program is a special service offered at no cost to Medicare members, it is not considered a benefit.

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 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 and a Medication Action Plan.

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

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 Medication List
Download PDF
English | Spanish

Call with questions

Phone: 1-888-686-4486
If you use a TTY: 711

Representatives are available Monday through Friday, 8 a.m. – 8 p.m., Eastern Time.

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