Wisconsin Medicare Prescription Drug Plans

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Medication Therapy Management Program

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What is the Medication Therapy Management (MTM) Program?

The Medication Therapy Management (MTM) Program is a service for customers with multiple health conditions and who take multiple medicines. The MTM Program helps you and your doctor make sure that your medicines are working to improve your health.

To qualify for the MTM Program, you must be eligible. Please see below for those details. If you qualify, you will be auto-enrolled into the program and the service is provided at no additional cost to you. You may choose not to participate in the program, but it is recommended that you make use of this free service.

The MTM Program is offered through our partnership with Express Scripts, Inc. and Tabula Rasa HealthCare, formerly SinfoniaRx. The MTM Program is not considered a part of the plan’s benefit.

Medicare beneficiaries may enroll in WPS MedicareRx Plan through the Centers for Medicare & Medicaid Services Online Enrollment Center, located on the official medicare.gov website.

Who is eligible for the MTM Program?

You may qualify for the MTM Program if:

1. You have three or more chronic health problems. These may include:

Asthma—respiratory disease
Chronic heart failure (CHF)
Chronic obstructive pulmonary disease (COPD)
Diabetes
Dyslipidemia
End-stage renal disease (ESRD)
High blood pressure/hypertension
Osteoporosis/arthritis/bone disease
Mental health—depression

2. You take eight or more daily medicines covered by Medicare Part D

3. You spend $4,376 or more per year on Part D covered medications

How does the MTM Program help you?

If you qualify for the MTM Program, you will be contacted and have the chance to speak with a highly trained pharmacist or a pharmacist intern who is under the direct guidance of a pharmacist. During that call, the pharmacist or pharmacist intern will complete a comprehensive medication review of your medicines and talk with you about:

Any questions or concerns about your prescription or over-the-counter medicines, such as drug safety and cost
Better understanding your medicines and how to take them
How to get the most benefit from your medicines

What will you receive?

If you qualify for the MTM Program, you will receive:

Welcome letter that tells you how to get started.
Full medication review:

You will have the chance to review your medicines with a highly trained pharmacist or a pharmacist intern under the direct guidance of a pharmacist each year. This review will take about 20-30 minutes. During this call any issues with your medicines will be discussed. The call can be scheduled at a convenient time for you.
After you complete the full medication review, a summary is mailed to you. The summary includes a medication action plan with space for you to take notes or write down any follow-up questions.
You also will be mailed a personal medication list that lists all of the medicines that you take and the reasons why you take them.
Click here to see an example of the full medication review letter.

Ongoing targeted medication reviews
- At least once every three months, your medicines will be reviewed, and you or your doctor will be contacted if you should think about any changes in your medicines.
- You may get a letter or a phone call for this review.

How can I learn more about the MTM Program?

For information about the MTM Program or to see if you qualify, you can call 1-800-688-1604 (TTY: 1-800-716-3231), 24 hours a day, seven days a week.

Call today for a free info kit!

Contact your local agent or call us at 1-800-731-0459 (TTY: 711)
8 a.m.-8 p.m., weekdays (year-round) and weekends (Oct. 1—March 31).