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
English | Spanish
Call with questions
If you use a TTY: 711
Representatives are available Monday through Friday, 8 a.m. – 8 p.m., Eastern Time.