Medicare Medication Therapy Management

The MetroPlus Health Plan Medication Therapy Management (MTM) program helps you get the greatest health benefit from your medications by:

• Preventing or reducing drug-related risks
• Increasing your awareness
• Supporting good habits

Who qualifies for the MTM program?
We will automatically enroll you in the MetroPlus Health Plan MTM program at no cost to you if all three conditions apply:

1. Have coverage limitation(s) in place for medication(s) with a high risk for dependence and/or abuse, or
2. Meet the following criteria:
   • You have three or more of these conditions:
     • Asthma
     • Chronic heart failure (CHF)
     • Chronic obstructive pulmonary disease (COPD)
     • Diabetes
     • Dyslipidemia
     • Hypertension
     • Chronic alcohol & drug dependence
     • HIV/AIDS
   • You take eight or more maintenance medications covered by your plan
   • You are likely to spend more than $4,696 in prescription drug costs in 2022

Your participation in the MTM Program is voluntary and does not affect your coverage. This is not a plan benefit and is open only to those who qualify. There is no extra cost to you for the MTM Program.

How will I know if I qualify for the MTM Program?
If you qualify, we will mail you a letter. You may also receive a call to set up your one-on-one medication review.

What services are included in the MTM program?
In the MTM Program, you will receive the following services from a health care provider:
•    Comprehensive medication review
•    Targeted medication review

What is a comprehensive medication review?
The comprehensive medication review is completed with a health care provider in person or over the phone. This review is a discussion that includes all your medications:

• Prescriptions
• Over-the-counter (OTC)
• Herbal therapies
• Dietary supplements

This review usually takes 20 minutes or less to complete. During the review, you may ask any questions about your medications or health conditions. The health care provider may offer ways to help you manage your health and get the most out of your medications. If more information is needed, the health care provider may contact your prescriber.

At the end of the review, the health care provider will provide you with a summary of what you discussed. The summary will include the following:

• Medication Action Plan. Your plan may include suggestions for you and your prescriber to discuss during your next visit
• Personal Medication List. This is a list of all the medications discussed during your review. You can keep this list and share it with your prescribers and/or caregivers

Who will contact me about completing the review?
You may receive a call from a pharmacy where you recently filled one or more of your prescriptions. You can choose to complete the review in person or over the phone.

A health care provider may also call you to complete your review over the phone. When they call, you can schedule your review at a time that is best for you.

Why is this review important?
Different prescribers may write prescriptions for you without knowing all the medications you take. For that reason, the MTM Program health care provider will:

• Review all your medications
• Discuss how your medications may affect each other
• Identify any side effects from your medications
• Help you reduce your prescription drug costs

How do I benefit from talking with a health care provider?
By completing the medication review with a health care provider, you will:

• Understand how to safely take your medications
• Get answers to any questions you may have about your medications or health conditions
• Review ways to help you save money on your drug costs
• Receive a Personal Medication List and Medication Action Plan to keep and share with your prescribers and/or caregivers

What is a targeted medication review?
The targeted medication review is completed by a health care provider who reviews your medications at least once every three months. With this review, we mail, fax, or call your prescriber with suggestions about prescription drugs that may be safer or work better for you. As always, your prescriber will decide whether to consider our suggestions. Your prescription drugs will not change unless you and your prescriber decide to change them. We may also contact you by mail or phone with suggestions about your medications.

How can I get more information about the MTM program?
Please contact us if you would like more information about the MetroPlus Health Plan MTM Program or if you do not want to participate. Our number is 1-844-635-3406, 24 hours a day, 7 days a week. TTY users, call 711.

How do I safely dispose of medications I don’t need?
The MetroPlus Health Plan MTM Program is dedicated to providing you with information about safe medication disposal. Medications that are safe for you may not be safe for someone else. Unneeded medications should be disposed of as soon as possible. You can discard your unneeded medications through a local safe disposal program or at home for some medications.

• Locating a community safe drug disposal site
  A drug take back site is the best way to safely dispose of medications. To find drug take back sites near you, visit the website below and enter your location:
  https://apps2.deadiversion.usdoj.gov/pubdispsearch/spring/main?execution=e2s1
  Some pharmacies and police stations offer on-site drop-off boxes, mail-back programs, and other ways for safe disposal. Call your pharmacy or local police department (non-emergency number) for disposal options near you.

• Mailing medications to accepting drug disposal sites
  Medications may be mailed to authorized sites using approved packages. Information on mail-back sites can be found at www.deatakeback.com.

• Safe at-home medication disposal
  You can safely dispose of many medications through the trash or by flushing them down the toilet. Visit the following website to learn more about safe at-home disposal:
  https://www.hhs.gov/opioids/prevention/safely-dispose-drugs/index.html

Follow these steps for medication disposal in the trash:

• Remove medication labels to protect your personal information
• Mix medications with undesirable substances, such as dirt or used coffee grounds
• Place mixture in a sealed container, such as an empty margarine tub

MetroPlus Health Plan is an HMO, HMO SNP plan with a Medicare contract. MetroPlus Health Plan has a contract with New York State Medicaid for MetroPlusHealth UltraCare (HMO-DSNP) and a Coordination of Benefits Agreement with the New York State Department of Health for the MetroPlus Advantage Plan (HMO-DNSP). Enrollment in MetroPlus Health Plan depends on contract renewal. MetroPlus Health Plan complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

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Last updated – 4/26/2022 8:59:35 PM