AAA

Medication Therapy Management

Better Understand Your Medication

What is the Medication Therapy Management (MTM) Program?

MTM is a program that helps you understand your medications and get better results.  MTM is a free program offered to you by Gateway Health Medicare AssuredSM. You do need to qualify, but if you do, you are eligible to speak with specially trained pharmacy staff over the phone about how to best take your medications, address your drug costs, or any other problems you may be having.  Note – these programs are not considered a benefit.

Participating in MTM can help you:

  • Get the most benefit from your medications and provide tips on how to remember to take your medications
  • Reduce the risk of side effects and interactions
  • Make sure you are receiving the most effective medications, possibly reducing cost

What you will receive if you participate:

  • A Medication Action Plan (MAP) that provides a summary of what you and the pharmacy staff talked about, including steps you should take to help you get the best results from your medications. 
    Download the Medication Action Plan (pdf)
  • A Personal Medication List of your medications and why you are taking them to help you keep track of your medications and how to use them the right way.
    Download the Personal Medication List (pdf)

If you chose to participate, the pharmacy staff may work together with you and your doctor to make sure that your medicines are working well for you. We encourage you to share the medication list and action plan with your health care providers. A pharmacist will also periodically review the medications you are filling at the pharmacy even if you decide not to talk with the pharmacy staff. A member of the pharmacy staff may reach out to you or your doctor if any issues are identified.

How Do I Know If I Qualify?

If you qualify, you should receive an introduction packet in the mail welcoming you to the program. You may also be contacted by phone to see if you are interested in setting up an appointment to review your medications. All appointments are over the phone, so you don't even have to leave your house. Appointments will normally take around 20 minutes depending on each individual. 

To qualify you must:

  • Have three of the following conditions:
    • Chronic Obstructive Pulmonary Disease (COPD)
    • Asthma
    • Depression
    • Bipolar Disorder
    • Hypertension
    • Dyslipidemia
    • Diabetes
    • Chronic Heart Failure (CHF)
    • Rheumatoid Arthritis
    • Osteoporosis
    • Hepatitis C
  • Be taking eight or more chronic maintenance drugs
  • For the year 2017 - Projected to exceed annual prescription medication costs of $3,919 which is calculated based on the previous quarter Part D medication costs greater than or equal to $979.75.

Medicare requires that Gateway HealthSM automatically enroll those who qualify, but participation is voluntary and you are given the opportunity to opt out at any time. Opting out will not change your insurance coverage in any way. If you would like to schedule an appointment, have questions about the program, or if you choose to opt out from the MTM program, please call 1-844-866-3735 Monday – Friday between the hours of 10 a.m. to 8 p.m. EST (TTY/TDD 1-800-367-8939).

Want to Learn More?

We would like to hear from you so that we can help you manage your medications better!  If you are unsure if you qualify or want to learn more, call and ask about the Medication Therapy Management or MTM program.

  • 1-800-685-5209 in Pennsylvania (TTY users: 711)
  • 1-888-447-4505 in Ohio (TTY users: 711)
  • 1-855-847-6430 in North Carolina (TTY users: 711)
  • 1-855-847-6380 in Kentucky (TTY users: 711)

If you would like a copy of a blank personal medication list, please call 1-844-866-3735 or Download the Personal Medication List (pdf).

Gateway HealthSM offers HMO plans with a Medicare Contract. Some Gateway Health plans have a contract with Medicaid in the states where they are offered.  Enrollment in these plans depends on contract renewal. The benefit information provided is a brief summary, not a complete description of benefits. For more information, contact the plan. These plans are available to anyone with Medicare and Medicaid.