Medication Therapy Management

Medication Therapy Management (MTM) is a Medicare Part D program for complex health needs provided to people who meet certain requirements or are in a Drug Management Program. MTM services usually include a discussion with a pharmacist or health care provider to review medications.

Upper Peninsula Health Plan (UPHP) MI Coordinated Health (HMO D-SNP) has our Pharmacy Benefit Manager, Express Scripts®, administer our MTM Program.  The program is structured to meet Centers for Medicare and Medicaid (CMS) compliance and intent by providing value driven health care for Medicare Part D beneficiaries.

This program is not considered a benefit; it is voluntary and free to members who qualify. This program helps you and your provider make sure that your medications are working to improve your health. If you qualify for the program, a pharmacist or other health professional will give you a comprehensive review of all of your medications and talk with you about:

• how to get the most benefit from the drugs you take
• any concerns you have, like medication costs and drug reactions
• how best to take your medications
• any questions or problems you have about your prescription and over-the-counter medication

Then, they’ll give you:

• A written summary of this discussion. The summary has a medication action plan that recommends what you can do for the best use of your medications.
• A personal medication list that includes all medications you take, how much you take, and when and why you take them.
• Information about safe disposal of prescription medications that are controlled substances.

It’s a good idea to talk to your prescriber about your action plan and medication list.

• Take your action plan and medication list to your visit or anytime you talk with your doctors, pharmacists, and other health care providers.
• Take your medication list with you if you go to the hospital or emergency room.

If we have a program that fits your needs, we enroll you in the program and send you information. If you don’t want to be in the program, let us know, and we’ll take you out of it.

For any questions, or to opt-out of the program, call Express Scripts® MTM Customer Service at 1-855-931-2782 (TTY: 711), Monday through Friday from 9 a.m. to 7 p.m. Eastern Time. The call is free.

You may also call your Care Coordinator at 1-877- 349-9324 (TTY: 711), Monday through Friday from 8 a.m. to 9 p.m. Eastern Time. The call is free.

Read the documents below for additional information:

• Medication Therapy Management Program (MTMP)
• Blank Personal Medication List