What is the purpose of the MTM Program?The MTM Program helps make sure that you understand how to take your medicines correctly, and addresses medicine-related problems such as side effects, use of higher-risk medicines and interactions between medicines. We can do this by talking to you about your medicines over the phone and by periodically reviewing your pharmacy claims throughout the year. We will communicate with you and your doctor if we find any medicine-related problems that we believe should be addressed.
Do you qualify for the MTM Program?To qualify for the MTM Program, you must meet all three of the following criteria:
- You have been diagnosed by your doctors with at least three of the following medical conditions: diabetes, high blood pressure, high cholesterol, chronic heart failure, osteoporosis, asthma, COPD or depression.
- You have filled prescriptions for at least eight covered Part D medicines in the current calendar year.
- You and others on your behalf (including Essence Healthcare) have paid at least $1,063.75 for your medicines in the previous three months.