OneCare (HMO SNP)

Medication Therapy Management

Or Medicine Review Program

We can help you stay healthy with the Medication Therapy Management (MTM) Program. It is also known as the Medicine Review Program. This program gives you the tools you need to get the most from your medicines. MTM services are not considered a benefit. We offer the MTM Program to members of OneCare (HMO SNP) at no cost.

The MTM Program is for members who are at a high risk of having adverse effects from the medicines they take. Through the MTM Program you can talk with one of our pharmacists at no cost. Our pharmacists teach you how to take your medicines in a safe and proper way. Taking your medicines the correct way can help prevent side effects. It can also lower your out-of-pocket costs.

Comprehensive medication review

As part of the MTM Program, a pharmacist does a comprehensive medication review (CMR) with you. Your CMR can be done in person or over the phone. Your CMR may take 30 to 60 minutes to complete.

During your CMR, the pharmacist looks at:

  • Why you are taking each of your medicines
  • If the medicines you are using are working for you
  • If your medicines are causing any side effects or making you sick
  • If your medicines affect each other, foods or over-the-counter medicines
  • If there are ways to lower the number of medicines you are taking

After meeting with a pharmacist, we will mail you a letter with:

  • A Recommended To-Do List that shares what was talked about at your CMR and what steps you should take to help you take your medicines safely
  • Information about how to safely dispose of unused prescription medicines
  • A Medication List that shows all your medicines, how to take them and why you take them
Document with arrow pointing down icon

Medication List Download PDF Icon Download the blank form to track other medicines or update your list.

Targeted medication reviews

Pharmacists perform targeted medication reviews (TMR) at least once each quarter. The pharmacist looks at only some of the medicines you take that could put you at risk for adverse effects. If you are at risk, the pharmacist will tell your doctor.

MTM eligibility requirement

Once a quarter, we select members to take part in the MTM Program. If you meet one or more of the groups below, we will mail you a letter to let you know you have been enrolled into the MTM Program.

Group 1: You are chosen for the MTM Program if A, B and C apply to you:

A. You receive medicines for 3 or more of the following conditions:

  • Diabetes
  • Asthma
  • Chronic Obstructive Pulmonary Disease (COPD)
  • Hypertension or high blood pressure
  • Dyslipidemia or high cholesterol
  • End-Stage Renal Disease (ESRD): This is determined from a prescription claim or diagnosis.

B. You are taking 8 or more medicines through OneCare per quarter

C. You will likely exceed $4,696 in medicine costs per year

Group 2: You are chosen for the MTM Program if:

1. It is determined that you are at high risk of having an adverse event or overdose due to your total opioid dose from multiple prescribers or pharmacies.

2. You have a recent history of opioid-related overdose.

If you have any questions or do not want to be part of this program and wish to opt out, call OneCare Customer Service at 1-877-412-2734 (TTY 711), 24 hours a day, 7 days a week. We have staff who speak your language.

How To Get Rid of Unused, Unneeded or Expired Medicines

Unused or expired medicines should be disposed of as soon as possible. Storing unneeded medicines at home can be a risk for others who may take them by mistake or abuse them.

The best way to dispose of medicines is through a take back program or site that will safely and securely dispose of your medicines.

When a take back option is not available, two options for disposing medicines at home include flushing down the toilet or throwing away in household trash.

        1. Remove the medicine from the container.
        2. Mix the medicine with a substance that cannot be consumed, such as coffee grounds or cat litter.
        3. Place the mixture in a sealed bag and throw it away in the trash.
        4. Remove all personal information on the label of the empty medicine container.

To learn more about how to safely dispose of medicines, visit www.hhs.gov/opioids/prevention/safely-dispose-drugs/index.html.

Be sure to review all your medicines with your doctor or pharmacist on a routine basis. Discard medicines as soon as you no longer need them.

Health Updates

Read the letters that are mailed to you once a quarter. These letters include updates on different health topics.

What Is a Statin? Who Needs It? 

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To file a complaint with Medicare, click on the following link to complete a complaint form on the Medicare website: Medicare Complaint Form.

H5433_22WEB001_2022_A (Accepted 9/25/2021)

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