Medication Therapy Management (MTM), while not part of a prescription drug benefit, 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 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 one-on-one review of your medicines with a pharmacist or other trained health care provider. 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 an issue is identified with your medications that require your or your prescriber's attention. If the MTM provider finds an 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 do I 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. 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), Osteoporosis, Diabetes, Dyslipidemia (Abnormal Cholesterol), or Chronic Obstructive Pulmonary Disease (COPD), AND
- Are taking eight or more chronic maintenance (Part D) drugs, AND
- Are likely to incur annual Part D Medication costs of $3967 for 2018 and $4,044 for 2019.
How am I notified of my MTM eligibility?
Once eligible, you will be auto-enrolled and will receive written notification within 60 days inviting you to participate in the program.
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 6 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 MTM provider may:
- 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 of 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 10-30 minutes.
For your convenience, you can print a blank medication list 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
Call with questions
Puerto Rico: 1-877-384-5282
Spanish (non-Puerto Rico): 1-800-337-8615
If you use a TTY: 711
Representatives are available Monday through Friday, 8 a.m. – 6 p.m. EST