Call our Pharmacy Customer Service line, 24 hours a day, 7 days a week.Call: 1-855-408-0010
For questions about MTMP, call the MTMP Hotline directly: 866-342-2183
Medication Therapy Management (MTM) is a pharmacy program offered by Virginia Premier CompleteCare (Medicare-Medicaid Plan), a Commonwealth Coordinated Care Plan. This program is at no cost to members and is targeted for those who are on multiple medications. Members may choose not to participate, but it is a recommended program. The goal of the program is to provide information to the members, their doctors and their pharmacists. This information will help improve medication use and coordination of care. This program is not considered a part of Virginia Premier CompleteCare’s benefit, and participation is optional.
MTM Program Eligibility
Members eligible for the MTM program will be identified on a quarterly basis. Members may qualify if they:
- Have 3 or more chronic health problems. Chronic health problems may include:
- Alzheimer’s Disease
- Bone Disease – Arthritis – Osteoporosis
- Respiratory Disease-Chronic Lung Disorders
- Take 8 or more daily Part D medications.
- Spend $3,919 or more per year on Part D covered medications. Membership is per calendar year and is re-evaluated annually.
How does the MTM program work?One of the goals of the program is to help increase our members’ knowledge of their prescriptions, OTC medications, herbal therapies and dietary supplements. If you qualify for the program, we will mail you a cover letter and a personal medication record (PMR), then a pharmacist will follow up by calling you.
- A highly-trained pharmacist will:
- Review all OTC medications, dietary supplements, and herbal products used.
- Develop a prioritized list of medication-related problems, and create an action plan and recommendation list for the patient and/or caregiver.
- Talk with you about any concerns that you may have.
What will be received?New members are identified to participate in the MTM on a quarterly basis. If you are identified for participation, you will receive:
- A cover letter indicating eligibility and enrollment in the MTM program.
- A Complete Medication Review (CMR) by a pharmacist to review all OTC medications, dietary supplements, and herbal products used.
- A personal medication record (PMR) – a list of all the medicines that you are taking and the reasons for their use.
- After the completion of a CMR, an individualized written summary will be mailed to you.
- General educational information will be mailed and are also available online at www.envisionrx.com/healthdrug.aspx.
- Once every 3 months, you will be contacted vial mail or phone for a review.
- Your primary care provider will receive a patient medication list along with any identified potential therapy care gaps for that member as identified in the applicable quarter.
- Prescribers will be re-notified regarding any unresolved therapy care gaps no more frequently than every 6 months.
Have Questions? Let’s talk.Call us at 1-855-338-6467, 8:00 a.m. to 8:00 p.m., Monday through Friday. For TTY/TDD services, please call 1-800-828-1120 (Text), 1-800-828-1140 (Voice). The call is free.
Virginia Premier CompleteCare is a health plan that contracts with both Medicare and the Virginia Department of Medical Assistance Services to provide benefits of both programs to enrollees.
Limitations, copays, and restrictions may apply. For more information, call Virginia Premier CompleteCare Member Services or read the Virginia Premier CompleteCare Member Handbook.
Benefits, List of Covered Drugs, and pharmacy and provider networks and/or copayments may change from time to time throughout the year and on January 1 of each year.
You can get this information for free in other languages. Call 1-855-338-6467, 8:00 a.m. to 8:00 p.m., Monday through Friday. For TTY/TDD services, please call 1-800-828-1120 (Text), 1-800-828-1140 (Voice). The call is free.
You can ask for this information in other formats, such as Braille or large print. Call 1-855-338-6467, 8:00 a.m. to 8:00 p.m., Monday through Friday. For TTY/TDD services, please call 1-800-828-1120 (Text), 1-800-828-1140 (Voice).
H3067_062515WEB CMS Approved