- prescription drugs
- utilization management
- Medication Therapy Management
Medication Therapy Management
Medications can play a key role in your healthcare. To get the most from them — and keep yourself safe — you need to know how to use them the right way. That’s not always as straightforward as it sounds. And it can be even harder when you need more than one drug.
That’s where our medication therapy management program can make a big difference. It doesn’t cost you anything, and it can help:
- Limit or prevent harm that medications may cause
- Make you more aware of how your medications improve your health — and what the risks and side effects are
- Support healthy habits that keep you safe and help you get the most from your drugs
If you qualify for the program, you’ll get a comprehensive medication review once a year. You’ll also get one or more targeted medication reviews. Our Medication Therapy Management (MTM) is a Medicare-designed program that we offer. It’s not part of your prescription drug benefit. Read on to learn more.
How do I know if I qualify?
The program is open to you if all 3 of the following are true:
- You take 8 or more maintenance drugs covered by Medicare Part D
- You have 3 or more of these long-term health conditions:
• Chronic heart failure
• High cholesterol
• High blood pressure
• Chronic obstructive pulmonary disease (COPD)
- You and your Devoted Health plan together reach $4,935 in yearly prescription drug costs
You could qualify if you're identified as an at-risk beneficiary (ARB) under the plan’s Drug Management Program (DMP) for potential misuse of opioid medications.
If you meet all these conditions, we’ll sign you up automatically and send you a letter to let you know. You may also get a phone call to set up your first review.
Do I have to take part in the program?
No, you don’t. You can take part only if we invite you to (it’s not open to all members), but it’s your choice to take part or not. And whether you do or don’t, it won’t affect your coverage.
Comprehensive Medication Review
For this review, you’ll talk 1-on-1 with a pharmacist or other qualified healthcare professional. They can answer your questions and talk through concerns you have about any of your medications, including:
- Prescription drugs
- Over-the-counter (OTC) medicines
- Herbal therapies
- Dietary supplements and vitamins
After the review, we'll send you a:
- Personal Medication List with all the medications you discussed
- Medication Action Plan, which may include ideas for you and your doctor to discuss during your next doctor’s visit
What will I get out of the review?
Different doctors may write prescriptions for you without knowing all the prescription drugs and OTC medications you take. We'll look at all of your medications across the board and:
- Discuss how your prescription drugs and OTC medications may affect each other
- Check if any prescription drugs and OTC medications may cause side effects — and offer suggestions to help
- Help you get the most from all of your prescription drugs and OTC medications
- Review ways to help you lower your prescription drug costs
The whole process can give you real peace of mind, knowing that you’re taking all your medications safely. And you might save some money.
Plus, you can share your Personal Medication List and Medication Action Plan with your doctors and health care providers to keep them aware of everything you’re taking.
How do I get ready for the review?
Fill out this blank copy of the Personal Medication List. This will help make sure that together, you and your pharmacist have all the information you need.
A typical review takes about 30 minutes, and you usually have it once a year.
Targeted Medication Review
This review happens behind the scenes. First, we take a look at the medications you’re taking. Then, we contact your doctor with suggestions about prescription drugs that may be safer — or work better — than your current drugs. We may also let you know about our suggestions.
You don’t have to make any changes — we’re just offering suggestions. It’s up to you and your doctor what to do with them.
How can I learn more?
Call us at 1-888-609-3532 (TTY 711). We're here 8am to 5pm, Monday to Friday.