Medication Therapy Management
Your patients may be eligible for free help with their medications. This program connects members to a pharmacist for free to help them better understand their medications and potentially save money.
What is the Medication Therapy Management (MTM) Program?
MTM is an annual check-up with a pharmacist. The pharmacist can help your patients understand why they take each medication, how well they work together, the best way to take them, and check for any medication-related problems as their health changes. MTM is not a plan benefit. It is a plan-required program by the Center of Medicare and Medicaid Services (CMS).
Our pharmacists are trained to help your patients get the best results from their medications. They know how and where to get prescriptions at the best price.
How do they join?
Your patients qualify for a free medication check if they have a Medicare drug plan and:
Have 3 or more of these conditions: Alzheimer's, osteoporosis, arthritis (osteoarthritis or rheumatoid), diabetes, high cholesterol, kidney disease, HIV/AIDS, high blood pressure, respiratory disease (asthma/COPD), depression, or bipolar disorder;
AND
Regularly take 8 or more medications;
AND
Expect to spend over $1,623 on medications in 2025.
Your patients may also qualify if they are a Medicare drug plan member who is considered “at-risk” by their doctor.
How do they start?
If your patients qualify, they will get a letter in the mail from Simply Prescriptions asking them to join the MTM program. The letter will tell them how to join. They may also get a call from a pharmacist to make an appointment. Your patients can also contact us directly to check if they can join.
Please instruct your patients to call our Medicare Customer Care Advocates at 1-877-883-9577 (TTY 711), Monday – Friday from 8 a.m. - 8 p.m. ET. Joining MTM is optional and won't change their Medicare drug coverage.
What should they expect during their medication review?
Each review will take around 20 minutes but may be as long as 40 minutes if there are a lot of different medications to discuss. The pharmacist will go over everything, including prescriptions, vitamins, and supplements. They can answer any medication questions your patients may have.
After the review, your patient will get a summary of their review and a medication list to help them track their medications and why they take them.
Working with your doctor
Throughout the year, the pharmacist will also do a targeted medication review to check for any problems with their medications. The pharmacist may call you if there’s a potential problem, an opportunity to improve care, or if your patient is unable to independently complete a review due to cognitive impairment. Their prescriptions will only change if you agree to make a change.
Cost savings
Joining the MTM program may also help your patients save money by suggesting lower-cost medications or places with lower copays.
How has MTM helped patients like yours?
One drug plan member stopped taking his high blood pressure medication because it cost too much money. Our MTM pharmacist helped find a lower cost choice that would still work. The pharmacist spoke to the doctor, who agreed to change the prescription to the lower cost medication. The patient’s cost dropped to less than $10 and the new medication kept him healthy.
During the review, our MTM pharmacist found two (2) medications that worked the same way to treat the same problem. One of the medications was accidentally added after a hospital stay. The pharmacist called the doctor who had the member stop one of the medications. This helped to stop side effects from happening and saved a copay.
Our MTM pharmacist found out that a member was treating herself with a medication every day even though her doctor asked her to take it “as needed.” The member didn’t know how to tell when she needed the medication or not. The pharmacist gave her directions to follow, and she was able to take it when she needed to only. The medication lasted longer with less use and the member felt like she knew exactly what to do.
A member told the MTM pharmacist she stopped taking a medication when the tablets were too big to swallow. Because she stopped her medication, she was not getting better. The pharmacist called the doctor and asked to change the medication to a liquid. A few days later the pharmacist called to check on the member. She had filled the new prescription, was able to swallow the liquid and was feeling much better!
Contact Us
For more information on the MTM program, please call our Medicare Customer Care Advocates at 1-877-883-9577 (TTY 711), Monday – Friday from 8 a.m. - 8 p.m. ET. They are available to take your call every day including Saturdays and Sundays from 8 a.m. - 8 p.m. ET. from October 1 to March 31.
