What is the Medication Therapy Management Program (MTM)?

Medication Therapy Management (MTM), while not part of a prescription drug benefit, is a Medicare-designed program offered by Humana.

We want to help you get the best results from all of the medications you’re taking. Talking to a trained healthcare provider can help you make sure your medications are working for you, identify potential lower-cost options and answer any questions or concerns you may have about your medications. 

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 1-on-1 review of your medications with a pharmacist or other trained healthcare provider. This review is called a Comprehensive Medication Review (CMR) and is offered at no extra cost to you. Once enrolled in the MTM program, you or your prescriber may be contacted about a Targeted Medication Review (TMR) if an issue is identified with your medications that requires attention. If the MTM provider finds an issue during a CMR or a TMR that requires your prescriber’s attention, the prescriber may receive a phone call or fax from the MTM provider. 

A trained pharmacist or healthcare provider will review your current medication program to:

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

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

Humana determines your eligibility every three months by looking at your medication claims information. If you qualify, you remain in the program for the rest of the calendar year. You’ll  have to requalify for the next year.* 

Humana’s criteria for 2024:

• You have 3 of the 5 following chronic diseases:
  • Osteoarthritis, CHF, Diabetes, Depression and/or COPD AND
• You are taking 8 or more chronic/maintenance (Part D) drugs, AND
• You’re likely to have annual Part D medication costs of $5,330 or more in 2024

OR

You qualified for the program because:

• You’re taking an opioid medication prescribed by more than 1 healthcare provider and/or using more than 1 pharmacy, OR
• You’ve had a drug-related hospital visit in the last 12 months and have been prescribed an opioid in the last 6 months

Once eligible, you will be enrolled automatically. Within 60 days, you’ll  receive an invitation to participate in the program.†

Then you can visit any participating pharmacy for an in-person consultation or call Humana directly to be put in touch with an MTM provider who can do your consultation over the phone.

You can call us at 888-686-4486 (TTY: 711), Monday – Friday, 9 a.m. – 5:30 p.m., Eastern Time.

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

Partner organizations: Aspen RxHealth, Outcomes and MedWatchers

For your convenience, you can print a blank medication list using the link below. Please use that form to keep track of all your prescriptions and over-the-counter medications.

Printable Personal Medication List – English

Printable Personal Medication List – Spanish

* Program eligibility is dependent upon your membership contract.

† 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 any individual MTM service at any time by calling 888-686-4486 (TTY: 711).