Medication Therapy Management Program

UnitedHealthcare’s Medication Therapy Management (MTM) program was developed by a team of pharmacists and doctors. The MTM program provides members with a comprehensive medication review (CMR) with a pharmacist or other qualified health care provider. The program helps members understand their drug coverage and how to use their medications, and also educates members of potentially harmful drug interactions and/or risks of side effects.

How to qualify

This program is available at no cost.  You’ll be automatically enrolled in the Medication Therapy Management Program if you:

  • take eight (8) or more chronic Part D medications, and
  • have three (3) or more long-term health conditions, and
  • are likely to spend more than $1,623 a year on covered Part D medications

OR

  • are in a Drug Management Program to help better manage and safely use medications such as those for pain

You need to have three or more of these health conditions to qualify for the Medication Therapy Management program.

  • Alzheimer’s disease
  • Bone disease-arthritis (including osteoporosis, osteoarthritis, and rheumatoid arthritis)
  • Chronic congestive heart failure (CHF)
  • Diabetes
  • Dyslipidemia
  • End-stage renal disease (ESRD)
  • Human immunodeficiency virus/ acquired immunodeficiency syndrome (HIV/AIDS)
  • Hypertension
  • Mental health (including depression, schizophrenia, bipolar disorder, and other chronic/disabling mental health conditions) and
  • Respiratory disease (including asthma, chronic obstructive pulmonary disease (COPD), and other chronic lung disorders) 

What you need to do

Within 60 days of becoming eligible for the MTM program, you’ll receive an offer by mail to complete a Comprehensive Medication Review (CMR). You may also receive this offer by phone or email.

You can complete the CMR by phone with a qualified health care provider. It takes about 30 minutes. A pharmacist, or qualified CMR provider, will review your medication history, including prescription and over-the-counter medications, and look for any issues.   

What's next

After completing a CMR, you’ll receive a packet containing a summary of the review including action items discussed and a list of the medications you are taking and why you take them.  This can be helpful when meeting with your doctor or pharmacist. The results may be sent to your doctor. In addition, members in the MTM program will receive information on the safe disposal of prescription medications including controlled substances.

You can also download a blank medication list for your personal use.

In addition to the CMR, Targeted Medication Reviews are done at least quarterly. This is done to find possible drug interactions or other medication concerns. Those reviews may be sent to your doctor.

MTM is not a benefit of your prescription drug plan, but a Medicare designed program offered at no cost by UnitedHealthcare. For more information on UnitedHealthcare’s Medication Therapy Management program, please call the phone number on your member ID card or you may call the OptumRx MTM clinical call center team at 866-216-0198, TTY 711, Monday – Friday 9 a.m. – 9 p.m. EST.