2023 Medication Therapy Management Program
To qualify for ApexHealth’s MTM program, you must meet one of the two following criteria:
- Be an At-Risk Beneficiary or
- Meet ALL of the following criteria:
- Have at least 3 of the following conditions or diseases: Chronic Heart Failure (CHF), Diabetes, Dyslipidemia, Hypertension, Asthma, COPD, AND
- Take at least 8 covered Part D medications, AND
- Are likely to have medication costs of covered Part D medications greater than $4,935 per year.
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 and review of all of your medications by a pharmacist or other health professional to help you use your medications safely. This review, or CMR, is provided to you confidentially via telephone by pharmacies operated by Tabula Rasa HealthCare. 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 ApexHealth. 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.
You can obtain a blank copy of the Personal Medication List (PML) that can help you and your health care providers keep track of the medications you are taking by checking the Documents and Forms section of our website at www.apexhealth.com
If you take many medications for more than one chronic health condition contact your drug plan to see if you’re eligible for MTM, or for more information, please contact Concierge Services at 1-844-279-0508 or, for TTY users, 711, 8 a.m. to 8 p.m., local time, seven days a week from October 1 through March 31, and 8 a.m. to 8 p.m., local time, Monday through Friday from April 1 through September 30.
If you have qualified for MTM, you can chat with us now about MTM at medwise.com/patient_experience.