Medication Therapy Management (MTM)

Our MTM program is a free service that is offered by AgeWell New York through Clinical Support Services (CSS) for members who meet our selected criteria described below. Please note that this program is not considered a benefit.

Under our MTM program, you will have access to the following free services:

  • A telephone consultation with a pharmacist to review your current prescriptions and over-the-counter medications
  • Ongoing comprehensive medication review

Advantages of the MTM Program include:

  • Ability to identify and reduce the chance for medication errors
  • More information about your current medication therapy
  • Opportunity to save money by reducing duplicative therapy and offering affordable formulary alternative availability if applicable
  • Chance to identify and educate you on the side effects of the drugs you are taking and discuss ways to reduce those effects
  • For more information about the MTM program and to schedule your free medication review with a pharmacist, please call the number on your MTM welcome letter. An MTM welcome letter is sent to you if you qualify for the program. You can also call Clinical Support Services (CSS) at 866-978-0475, between the hours of 9 AM to 8 PM(EST) Monday to Thursday and 9 AM to 6 PM on Friday, TTY 1-855-405-8233, for additional information.

What is the Medication Therapy Management (MTM) program?

The MTM program is designed to help our AgeWell New York members deal with multiple medications and illnesses. This program is another way to help you get the safest, most effective and affordable prescription drugs. Our staff works with individual members and their health care providers to be a source of information and support for medication management.

How does it work?

Once you are selected for our MTM program, you will receive a welcome letter from our MTM vendor and information about MTM. Our MTM vendor will contact you to schedule a telephone consultation with a pharmacist. The pharmacist will conduct a comprehensive medication review to identify any potential medication related issues. If any medication issue is identified during the telephone consultation with a pharmacist, we will discuss it with your provider. Participation in this program is voluntary. You can contact Clinical Support Services (CSS) at 866-978-0475, between the hours of 9 AM to 8 PM(EST) Monday to Thursday and 9 AM to 6 PM on Friday, TTY 1-855-405-8233 to opt-out of the program.

How can the program help the participant?

Our licensed pharmacists will assist you by being a source of knowledge about prescription and over-the-counter drugs. We can answer questions you may have about your medications and discuss potential drug therapies with your providers. Overall, our goal is to make sure you are getting and taking the types of medication that are right for you.

Who is eligible for the program?

Eligible participants are those members with Medicare Part D prescription coverage who take at least 8 (eight) Part D drugs and are likely to incur or exceed annual costs of the CMS dictated threshold for all covered Part D drugs.

Participants of the program also have at least 3 (three) of the below mentioned diseases of the following conditions:

  • Alzheimer’s Disease
  • Bone Disease ­Arthritis­ Osteoporosis
  • Diabetes CORE: Dyslipidemia CORE
  • Hypertension CORE
  • Respiratory Disease­ Chronic Obstructive Pulmonary Disease (COPD)
  • Chronic Heart Failure (CHF)
  • Dyslipidemia
  • Respiratory Disease-Asthma
  • Anticoagulation

You are not required to participate in this program if you do not wish to do so. You can contact Clinical Support Services (CSS) at 1-877-330-9750, between the hours of 9 AM to 8 PM(EST) Monday to Thursday and 9 AM to 6 PM on Friday, TTY 1-855-405-8233 to opt-out.

How long does the program last?

The program runs from the time that the member meets eligibility requirements until the end of the calendar year. You may be auto enrolled in the program the following January if you want to participate in the program, and you continue to meet the requirements for the new contract year.

Comprehensive Medication Review

Each eligible MTM member’s drug information is analyzed for potential drug-drug interactions, possible adverse effects of medications, or gaps in care. Every quarter, we automatically enroll qualified members in CSS’s MTM program so they may begin receiving this extra support. Eligible MTM members will receive a letter notifying them that they have been auto-enrolled into the MTM Program.

As an MTM member, you are also eligible to receive a comprehensive medication review (CMR). We will offer you CMR participation by mail and in some cases by phone. The CMR will give you the opportunity to review all of your current medications with a pharmacist. This is a one-on-one, conversation by phone that takes about 30 minutes. After completing the CMR, you will be mailed a personal medication list (PML) and a medication action plan (MAP). The PML will include your current prescription medications, over-the-counter medications and dietary and herbal supplements. You can obtain a blank PML by using this link. The MAP will summarize what you and the pharmacist discussed during the CMR and discussion topics for you and your doctor. We will also conduct ongoing Targeted Medication Reviews (TMRs) and your doctor may be contacted by mail if we identify any issues with your medications.

Although we encourage members to take advantage of our valuable program, you do have the option to opt out of the program. If you do not want to take part in the program or if you have questions, please call the MTM Department at 1-877-330-9750. TTY/TDD users may call 1-855-405-8233. The MTM department is available Monday through Thursday 9 a.m. to 8 p.m. and Friday from 9 AM to 6 pm Eastern Standard Time.