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2023 Medication Therapy Management

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 our Pharmacy Benefits Manager, RxAdvance, 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 $1,234 in the previous quarter, and have documented illnesses in at least three of these chronic conditions:

PPO CSNP
  • Alzheimer’s Disease
  • Bone Disease-Arthritis-Osteoporosis
  • End-Stage Renal Disease (ESRD)
  • Mental Health-Bipolar Disorder
  • Mental Health-Depression
  • Respiratory Disease-Asthma
  •  Bone Disease-Arthritis-Osteoporosis
  • Chronic Heart Failure (CHF)
  • Diabetes
  • Dyslipidemia
  • Hypertension

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 RxAdvance MTM Department at 1-866-991-4322 (TTY: 711) weekdays from 9am-5pm EST.