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If you receive your Medicare Part D drug coverage through Tufts Health Plan Medicare Preferred, you may be eligible for a Medication Therapy Management (MTM) program.
This program was created to help us provide better care for our members. We have partnered with Outcomes MTM to provide this important service. Specially trained pharmacists, from a pharmacy call center (such as MedWatchers or CHC Health), will work with you and your doctor to make sure that your medications are appropriate, safe, and effective. We will also look for ways to save you money while optimizing your therapy/treatment. Our MTM team will review your medications for any potential issues and notify your provider if any are found. This program is not considered a benefit and is a free service for eligible beneficiaries. Participation in the program is always voluntary, and you may choose not to participate or disenroll at any time.
Enrollment in this program is automatic if you meet specific criteria based upon:
As a member of Tufts Health Plan Medicare Preferred, you will be automatically enrolled in the Medication Therapy Management (MTM) program if you meet the following criteria:
You have at least three (3) of the following chronic conditions:
Chronic Obstructive Pulmonary Disease (COPD)
High Blood Pressure (Hypertension)
High Cholesterol (Dyslipidemia)
Chronic Heart Failure (CHF)
You have claims for six (6) or more different covered Part D medications
You have at least $4,255 in estimated annual drug costs for covered Part D medications
If you are eligible for the MTM program, you will receive a Welcome letter from our MTM Partner, OutcomesMTM. Within a few weeks of receiving the letter, you will receive a call from MedWatchers of CHC Health to set up an appointment to speak to a clinical staff member and to complete the Comprehensive Medication Review (CMR). We encourage you to take full advantage of this service.
The Comprehensive Medication Review or “CMR” is done over the phone by a pharmacist or other qualified provider. Your medication history (prescription and over-the-counter), lifestyle, and medical history will be reviewed. Based on this information, the pharmacist may offer recommendations or suggestions related to medication therapy. Then, a Medication Action Plan (MAP) summarizing any concerns and a Personal Medication List (PML) is sent to you by mail within 14 days. This information, along with any recommendations, is also sent to your physician. A CMR for all eligible members is done at least once a year and should take between 15-20 minutes.
In addition to the CMR, Targeted Medication Reviews (TMR) are conducted four times a year. During a TMR, the Pharmacist will assess your medication use and monitor for any new potential drug therapy issues. Any recommendations that are identified, will be sent to your Physician.
Tufts Health Plan Medicare Preferred Members:
Print a blank copy of the Personal Medication List (PML)(PDF) to keep for your records and share with your Provider. You may also contact our Customer Relations Department to request a copy.
For additional information regarding Tufts Health Plan Medicare Preferred’s MTM Program, please contact our Customer Relations department. HMO members should call 1-800-701-9000 (TTY: 711). Senior Care Options members should call 1-855-670-5927 (TTY: 711).