Medication Therapy Management Program (MTM)
The Medication Therapy Management Program (MTM) is designed to help eligible members with multiple conditions reconcile their medication profile and identify and resolve any drug related problems in order to optimize therapeutic outcomes. MTM Program is individualized, voluntary and complimentary to the drug coverage. The benefits of the program include a complete evaluation of the drug therapy to ensure adequate and safe use of medications. This assessment comprehends education and recommendations to the member, as well as for the physician or other health care professionals. This program is not considered a benefit of the drug coverage, however it is offered at no additional cost to the member.
MTM Program participation criteria:
Members will automatically enter the program if they meet the following three criteria:
• Having incurred in expenses of Part D drug coverage, up to $991.75 in the last three months or $3,967.00 during the last 12 months, if they have at least three chronic conditions as listed above and are using at least eight drugs of the selected therapeutic classes. If the member does not want to participate in the program, they can choose not to participate.
• Having at least three chronic conditions as listed below:
1. Congestive Heart Failure (CHF)
3. High Cholesterol
4. High Blood Pressure
5. Chronic Obstructive Pulmonary Disease (COPD)
6. Bone disease/ Rheumatoid Arthritis
7. Bone disease/Arthritis: Osteoarthritis
8. End Stage Renal Disease
• Being using at least eight medications covered under Medicare Part D included in the following therapeutic classes:
1. Drugs for high cholesterol
2. Cardiovascular drugs
a. Angiotensin Converting Enzyme Inhibitors (ACE)
b. Angiotensin II Receptor Blockers (ARBs)
c. Beta Blockers
g. Digitalis glycosides
h. Calcium Channel Blockers
3. Asma/COPD drugs
a. Inhaled corticosteroids
4. Diabetes drugs
b. Oral hypoglycemic
5. Rheumatoid arthritis/osteoarthritis Drugs
b. Non-steroidal Anti-inflammatory Drugs
c. Tumor Necrosis Factors (TNFs)
MTM Services and Materials
The services provided to the member enrolled in the program include:
Download a copy of the Personal Medication List.
For more information contact us at 787-523-2397 (Metro Area), 1-844-660-1660 (toll free), or at 1-866-333-5469 TTY (hearing impaired), Monday through Friday from 8:00 a.m. to 5:00 p.m.
Medicare y Mucho Más (MMM) (HMO), PMC Medicare Choice (PMC) (HMO) and FIRST+PLUS (PPO), products offered by MMM Healthcare, LLC, are plans with a Medicare contract. Enrollment in the plans depends on contract renewal. To enroll, you must have Medicare Parts A and B, have not been diagnosed with End Stage Renal Disease (ESRD) and reside within the 78 municipalities of the Island. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premium and/or co-payments/co-insurance may change on January 1 of each year. You must continue to pay your Medicare Part B premium. The Formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary. Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next. MMM Healthcare, LLC complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. MMM Healthcare, LLC cumple con las leyes federales de derechos civiles aplicables y no discrimina por motivos de raza, color, nacionalidad, edad, discapacidad o sexo. ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame a MMM al 1-866-333-5470, (TTY: 1-866-333-5469); PMC al 1-866-516-7700 (TTY: 1-866-516-7701); y First+Plus al 1-888-767-7717 (TTY: 1-877-672-4242). MMM Healthcare, LLC遵守 用的 邦民 法律 定，不因 族 適聯權規種色、民族血 、年 、 障 或性 而歧 任何人。注意：如果您使用繁 中文，您可以免 得 言援助服 。 致 膚統齡殘別視體費獲語務請電MMM 1-866-333-5470, (TTY: 1-866-333-5469); PMC 1-866-516-7700 (TTY: 1-866-516-7701); First+Plus 1-888-767-7717 (TTY: 1-877-672-4242).
H4003-MMM Healthcare, LLC H4004-PMC Medicare Choice H7522-MMM Healthcare, LLC Y0049_2018 4006 0001 1 CMS Approved 10042017
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