Medication Therapy Management

Pharmacists in the Premier MTM Network through Medica have met credentialing standards developed by the medical plan showing that they have received education on delivering MTM services.

MTM pharmacists are based out of health system clinics or pharmacies. To locate MTM providers, visit your plan page and click on "Find an MTM Provider":

• Medica Elect/Essential plan
• Medica Choice Regional plan
• Medica Choice National/HSA plan
• ACO: call the scheduling/appointment number for your ACO and ask for an MTM provider

For your first meeting, bring your Medica and Prime Therapeutics ID cards and all of your prescription and over-the-counter medication bottles or a complete list of your current prescriptions (including dosage and frequency), over-the-counter medications, herbal supplements, and vitamins. You can use My Medicine Record (pdf) to list your medications.

Your MTM meeting will be held in a private room in the pharmacy or the clinic where you will sit down one-on-one with your MTM pharmacist. The space will be large enough to accommodate at least three people without others being able to hear the MTM consultation and without distractions from other conversations in the facility. The pharmacist will ask you questions about your medical conditions, your medical history, and current and past medication use to check if there are any problems with your current medications.

With your permission, the pharmacist will contact your primary care provider and give their assessment and recommendation. Your pharmacist will work closely with your primary care provider to make your health care as effective as possible and fix any medication-related problems.

In the HSA plan, your deductible and coinsurance will apply, and you will pay the cost of the consultations and your prescription medications. You can choose to use your HSA account to cover some costs. The benefit for participating comes from the advice and helpful discussion with the MTM pharmacist to understand your medications better.

For members with diabetes, you can participate in the MTM program no matter how many medications you take, and the medical plan will pay the cost of the face-to-face consultations with the MTM pharmacist. By meeting privately with a specially trained pharmacist, you'll get the help you need to better understand your medications and improve your health. The pharmacist does a careful review of your medications, helps you set goals, and works directly with you and your physician on a regular basis to make sure that each medication is appropriate, safe, and effective.

You can also better manage your diabetes by participating in condition management or lifestyle management health coaching through the Wellbeing Program and earn more wellbeing points.

You can earn 500 Wellbeing Points per visit (1,000 max per year) for meeting with an MTM pharmacist two times or more between September 1 and August 31 each program year and working with the pharmacist and your doctor to make appropriate changes in your medication therapy. Learn more about earning Wellbeing Points on the Wellbeing Program web page.