Medicare Advantage Members

Managing complex health conditions and multiple medications can be a lot of work. The good news is that you may be eligible for a Medication Therapy Management (MTM) program with Medicare drug plan coverage. Quartz Medicare Advantage (HMO) offers MTM at no cost to you, helping to manage your medications well so that you can focus on feeling well.

With this program, pharmacists from our partner, MedWiseRx™, carefully review your medicines and health conditions. They look for ways to improve your health and reduce the risk of potential medication issues – and they’re ready to talk to you about your medicines.

Two types of medication reviews

The MTM program offers two types of prescription reviews at no cost to you:

A targeted medication review

At least four times a year, we’ll review all your prescription medications. We’ll contact you, your caregiver, your pharmacist, and/or your doctor if we notice a potential problem.

A Comprehensive medication review

At least once a year, you can review all your prescriptions with a pharmacist or other health professional. This takes about 30 minutes and can typically be done by phone, but sometimes may be done via telehealth, or in person at your health care provider’s office, the pharmacy, or a long-term care facility.

If you or your caregiver can’t be there for the review, we can complete the review directly with your provider.

After the review, you’ll get a written summary of the call or visit. You can take the summary with you when you talk with your doctors. It includes:

• A Recommended To-Do List – This action plan outlines steps you should take to get the best results from your prescriptions.
• A Personal Medication List (PML) – This list will help you keep track of your prescriptions and use them correctly.

Do I qualify for the MTM program?

To qualify, you need to be identified as an at-risk beneficiary* or meet all the following three criteria:

1. Have at least three of the following conditions or diseases:

• Asthma
• Chronic Heart Failure (CHF)
• Chronic Obstructive Pulmonary Disease (COPD)
• Depression
• Diabetes
• End-Stage Renal Disease (ESRD)
• Osteoarthritis

2. Take at least eight covered Part D medications for your chronic diseases.

3. Be likely to have medication costs (of covered Part D medications) greater than $4,935 per year.

Get organized

You can download a blank copy of the Personal Medication List (PML) to help you and your health care providers keep track of your medications.

We’re here for you

For more information, please call a Quartz Medicare Advantage Customer Champion at (800) 394-5566 (TTY:711), Monday – Friday, 8 a.m. to 8 p.m. Oct. 1 – March 31, seven days a week, 8 a.m. to 8 p.m. 

You may also visit medwisehc.com/patient-experience to learn more about the benefits of having MedWiseRx™ on your side. (By clicking on this link, you will leave the Quartz Medicare Advantage website)

*An at-risk beneficiary has been determined to be at-risk for misuse or abuse of frequently abused drugs, is not an exempted beneficiary, and meets one of the following:

• Has obtained frequently abused drugs from multiple prescribers and/or pharmacies, takes a high level of frequently abused drugs, or both
• Has a history of opioid-related overdose and at least one recent claim for an opioid medication that isn’t used for medication-assisted therapy