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Page Updated On 06/27/2022

Medicare Advantage Members

Medication Therapy Management

If you’re covered by a Medicare drug plan and have complex health needs, you may be eligible for a medication therapy management (MTM) program. Quartz Medicare Advantage (HMO) offers MTM at no cost to you.

This program helps reduce the risk of potential medication issues by offering two different kinds of free reviews of your prescriptions

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.

Comprehensive medication review.

At least once a year, we’ll give you the chance to review all your prescriptions with a pharmacist or other health professional. This takes about 30 minutes and can be done over the phone, 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, Quartz Medicare Advantage can also complete it directly with your provider.

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

  • A Medication Action Plan (MAP):  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 the right way.

How do I know if I qualify for Quartz Medicare Advantage’s MTM program?

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

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

  • Anticoagulation.
  • Asthma.
  • Atrial Fibrillation.
  • Autoimmune Disorders.
  • Cancer.
  • Cardiovascular Disorders.
  • Chronic Heart Failure (CHF).
  • Chronic Alcohol and Other Drug Dependence.
  • Chronic Obstructive Pulmonary Disease (COPD).
  • Diabetes.
  • End-Stage Renal Disease (ESRD).
  • HIV/AIDS.
  • Neurologic Disorders.
  • Osteoarthritis.
  • Osteoporosis.
  • Rheumatoid Arthritis.

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

3. Be likely to have medication costs (of covered Part D medications) greater than $4,696 per year.

You can get a blank copy of the PML here to help you and your health care providers keep track of your medications.

For more information, please call Quartz Medicare Advantage Customer Success 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.

*An at-risk beneficiary:

  • Is someone who might be at risk for misuse or abuse of frequently abused drugs.
  • Is not an exempted beneficiary.
  • Meets at least one of the following clinical guidelines:
  • Has obtained frequently abused drugs from multiple prescribers 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.

Medicare Advantage Drug Information

Looking for information on your drug plan? Find answers to your questions and view the drug list.