Pharmacy Plan Coverage

Medication Therapy Management

2025 2024

Prescriptions / Medication Therapy Management

Medication Therapy Management for Medicare Advantage Plans

HealthTeam Advantage offers a Medication Therapy Management (MTM) Program at no additional cost for our qualified Medicare members. This program is separate from the prescription drug plans we already offer. A team of pharmacists and doctors at Clarest Health AI LLC developed and maintains the program, which gives members additional support with their Part D medications.

We use criteria established by Medicare to identify eligible members. To be eligible, you must be filling at least eight Part D prescription drugs per month, have had accumulated drug costs of at least $1,623 in the previous quarter, and have documented illnesses in at least three of these chronic conditions:

Alzheimer’s Disease
Bone disease-arthritis (including osteoporosis, osteoarthritis, and rheumatoid arthritis)
Chronic congestive heart failure (CHF)
Diabetes
Dyslipidemia
End-stage renal disease (ESRD)

Human immunodeficiency virus/Acquired immunodeficiency syndrome (HIV/AIDS)
Hypertension
Mental health (including depression, schizophrenia, bipolar disorder, and other chronic/disabling mental health conditions)
Respiratory Disease (including asthma, chronic obstructive pulmonary disease (COPD), and other chronic lung disorders)

Each eligible 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 HealthTeam Advantage’s MTM program so they may begin receiving this extra support. Eligible MTM members will receive a letter notifying them they’ve been auto enrolled into the MTM Program.

MTM members can also receive a Comprehensive Medication Review (CMR) providing a chance to review all your current medications with a pharmacist, nurse, or other qualified healthcare professional. This 30-minute phone conversation results in a Personal Medication List (PML) and Medication Action Plan (MAP). The PML lists your current prescription medications, over-the-counter medications, and dietary and herbal supplements. (Click here for a blank Personal Medication List.) The MAP summarizes what was discussed in the CMR and includes discussion topics for you and your doctor. We’ll also conduct ongoing Targeted Medication Reviews (TMRs); your doctor may be contacted if we identify any issues with your medications.

Although we encourage members to take advantage of our valuable program, you can opt out. If you don’t want to participate, or if you have questions, please call the Clarest Health AI LLC MTM Department at 1-866-978-4695 (TTY: 711) Monday-Thursday 9am-7pm ET, Fri 9am-5pm ET, and Saturday 9am-1pm ET.

Corporate

300 E. Wendover Ave., Suite 121, Greensboro, NC 27401

Local Benefit Center

Walk-Ins Welcome

5815 Samet Dr., Suite 107, High Point, NC 27265

HealthTeam Advantage, a product of Care N’ Care Insurance Company of North Carolina, Inc., is a PPO and HMO Medicare Advantage plan with a Medicare contract.  Enrollment in HealthTeam Advantage depends on contract renewal.

Limitations, copayments, and restrictions may apply. Benefits, premiums and/or copayments/coinsurance may change on January 1 of each year. The formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary. Every year, Medicare evaluates plans based on a 5-star rating system.

Pharmacy Plan Coverage

Medication Therapy Management

Medication Therapy Management for Medicare Advantage Plans

Corporate

Local Benefit Center

Walk-Ins Welcome

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