If you’re in a Medicare drug plan and you have complex health needs, you may be able to participate in a medication therapy management (MTM) program. MTM is a service offered by Quartz Medicare Advantage at no additional cost to you!
The MTM program is required by the Centers for Medicare and Medicaid Services (CMS) and is not considered a benefit. This program helps you and your doctor make sure that your medications are working. It also helps to identify and reduce possible medication problems.
To take part in this program, you must meet certain criteria set forth in part by CMS. These criteria are used to identify people who have multiple chronic diseases and are at risk for medication-related problems. If you meet these criteria, we will send you a letter inviting you to participate in the program. Along with the letter, we will include information, including how to access the program. Your enrollment in MTM is voluntary and does not affect Medicare coverage for drugs covered under Medicare.
To help reduce the risk of possible medication problems, the MTM program offers two types of clinical review of your medications:
- Targeted medication review: at least quarterly, we will review all your prescription medications and contact you, your caregiver, your pharmacist, and/or your doctor if we detect a potential problem.
- Comprehensive medication review: at least once per year, we offer a free discussion to review of all of your medications with a pharmacist or other health professional. This review, or CMR, is provided to you confidentially via telephone. The CMR may also be provided in person or via telehealth at your provider’s office, pharmacy, or long-term care facility. If you or your caregiver are not able to participate in the CMR, this review may be completed directly with your provider. These services are provided on behalf of Quartz Medicare Advantage. This review requires about 30 minutes of your time. Following the review, you will get a written summary of this call, which you can take with you when you talk with your doctors. This summary includes:
- Medication Action Plan (MAP): The action plan has steps you should take to help you get the best results from your medications.
- Personal Medication List (PML): The medication list will help you keep track of your medications and how to use them the right way.
To qualify for Quartz Medicare Advantage’s MTM program, you must meet ALL of the following criteria:
1. Have at least three (3) of the following conditions or diseases:
- Atrial Fibrillation
- Autoimmune Disorders
- Cardiovascular Disorders
- Chronic Heart Failure (CHF)
- Chronic Alcohol and Other Drug Dependence
- Chronic Obstructive Pulmonary Disease (COPD)
- End-Stage Renal Disease (ESRD)
- Neurologic Disorders
- Rheumatoid Arthritis; AND,
2. Take at least six (6) covered Part D medications for your chronic diseases; AND,
3. Are likely to have medication costs of covered Part D medications greater than $4,376 per year.
You can obtain a blank copy of the PML to help you and your health care providers keep track of the medications you are taking. For more information, please contact Quartz Medicare Advantage Customer Service at (800) 394-5566.