Medication Therapy Management Program

The Medication Therapy Management (MTM) program is a free service for eligible Providence Medicare Advantage members.

The MTM program helps to ensure that your medications are working to improve your health by improving medication use and reducing the risk of adverse events, including adverse drug interactions. MTM services may be provided by a clinical pharmacist or other qualified provider.

Services provided by the MTM program include

  1. Recommendations regarding your medications for you and your prescriber
  2. An annual complete review of your prescription medicines, over-the-counter medicines, and vitamins or herbal supplements in consultation with the clinical pharmacist
  3. Shorter, more specific (or “targeted”) medication reviews completed throughout the year 

The Providence Medicare Advantage MTM program was developed in cooperation with licensed and practicing pharmacists and physicians. The MTM program is voluntary and free for eligible members, included with your part D plan. This service is offered by Providence Medicare Advantage Plans to its members and is not considered part of your insurance benefit package. 

How does this program help me?

It is estimated that 1.5 million preventable adverse drug events occur in the United States each year. Clinical pharmacist-provided MTM services can help to prevent these events and are associated with improved medication use, lower drug costs, improved disease management, reduced hospitalizations and reduced hospital readmissions.

The MTM program helps make sure you get the most out of your medications. As part of the MTM program, each member will receive an offer of a telephone consultation with the clinical pharmacist. This consultation usually takes 20 to 40 minutes and consists of a comprehensive medication review (CMR) of all your medications.

The clinical pharmacist will:

  • Complete a full review and assessment of your medications, including prescription and over-the-counter medicines, supplements, etc.
  • Talk with you about any questions you have such as:
    • What is this medication for?
    • Do I need to take this medication?
    • Am I getting the most out of this medication?
    • Am I using this medication safely?
    • Are these herbal medications okay to take?
    • Is this medication causing a side effect?
    • Is there a more affordable option?
    • Am I getting the most out of my Medicare part D benefit?
  • Help you:
    • Better understand your medicines
    • Resolve any issues with taking your medications
    • Reduce your risk for serious medication reactions
    • Identify different, more affordable medicine options
  • Mail you a summary of your consultation to share with your doctor

The summary you will receive following the telephone appointment includes a medication action plan that recommends what you can do to make the best use of your medications, with space for you to take notes or write down any follow-up questions. You will also get a personal medication list that will include all the medications you’re taking and why you take them. You may also print a blank medication form (PDF).

Targeted medication reviews (TMRs) are also conducted throughout the year. These TMRs address specific or potential medication-related problems and are used to assess medication use and monitor whether any unresolved issues need attention. TMRs may or may not require an additional 10-15 minute telephone conversation during the year.

Am I eligible?

You are eligible for services offered by Providence Medicare Advantage Plan’s MTM Program if you:

  • Are a member of Providence Medicare Advantage prescription drug plan
  • Use 7 or more part D medications
  • Have 3 or more chronic health conditions including, but not limited to:
    • Diabetes
    • Hyperlipidemia
    • Hypertension
    • Heart Failure
    • COPD
    • Osteoporosis
    • Rheumatoid arthritis
    • Asthma
  • Have a yearly drug spend that may be  difficult to afford (greater than about $3500)

You are also eligible to take part in this program if you or your doctor thinks you may benefit from a comprehensive review of your medications. For example, if you take multiple medications to treat chronic conditions, you may benefit from a detailed review of these medications with one of the clinical pharmacists.

How will I know I am eligible?

If you are eligible based on the above criteria, we will automatically enroll you in the program and mail information to you. We will call you to schedule a telephone appointment with the clinical pharmacist. You may also request MTM materials and information by calling the phone number listed at the bottom of this page. If you decide not to participate, please notify us and we will disenroll you from the program.

You may also enroll yourself. If you or your doctor feels that you would benefit from this service, simply call the Providence MTM Team at 877-216-3644 (opt #3) and have your Providence Medicare Advantage card available. The MTM team will take care of the brief enrollment steps and set up your appointment.

Make the most of your appointment

Follow these helpful tips:

  • Schedule your convenient MTM telephone appointment three to four weeks before your annual wellness exam with your physician.
    • The clinical pharmacist can help you organize your concerns and questions.
    • This can help you make the most of your appointment time with your physician.
  • Schedule your appointment for a time when you won’t be interrupted or distracted.
  • Be sure to have you medicines on hand, including your over-the-counter drugs and supplements.
  • Have a pen and paper to take notes.
  • Write down questions you have about your medicines before your appointment. Examples of common questions include:
    • What is the purpose of this medicine?
    • How and when do I take this medicine?
    • What should I do if I miss a dose?
    • Does this medicine have any side effects?
    • What should I do if a side effect occurs?
    • How and where should I store my medicine?
    • Should I avoid any medicines or dietary supplements, drinks, foods or activities while using my medicine? 
  • Be ready and available at the agreed upon time for your telephone appointment.

What do I do if I have more questions about this program?

To contact Customer Service, please call 503-574-8000 or 1-800-603-2340 (TTY: 711) between 8 a.m. and 8 p.m., 7 days a week.

Providence Medicare Advantage Plans is an HMO, HMO-POS, and HMO SNP plan with a Medicare and Oregon Health Plan contract. Enrollment in Providence Medicare Advantage Plans depends on contract renewal.

H9047_2017RCGA01 Website is current as of 09/01/2016