The Medication Therapy Management (MTM) program is a service for members 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 IngenioRx, CVS Caremark and OutcomesMTM. The MTM program is not considered a part of the plan's benefit.
You may qualify for the MTM Program if:
- You have 3 or more chronic health problems. These may include:
- Chronic Heart Failure (CHF)
- Rheumatoid Arthritis (RA)0
- You take 8 or more chronic maintenance medicines covered by Medicare Part D
- You spend $4,696 or more per year in 2022 on Part D covered medications
Additionally, members that are enrolled in their Health Plan's Drug Management Program(s) may be auto-enrolled in the MTM program.
If you qualify for the MTM Program, you will be contacted and have the chance to speak with a highly-trained pharmacist or other health professional. During that call, the pharmacist or other health professional will complete a comprehensive medication review (CMR) 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
If you qualify for the MTM program, you will receive:
- Welcome letter and/or phone call that tells you how to get started.
- Comprehensive Medication Review (CMR))
- You will have the chance to review your medicines with a highly-trained pharmacist or other health professional. The CMR typically takes about 15-30 minutes, depending on your needs. During this call any issues with your medicines will be discussed.
- The CMR can be scheduled at a convenient time for you.
- The CMR may also be provided in person at your provider’s office, pharmacy, or long-term care facility.
- After you complete the CMR, a summary is mailed to you. The summary includes a medication action plan (MAP) with space for you to take notes or write down any follow-up questions.
- You also will be mailed a personal medication list (PML) that lists all of the medicines that you take and the reasons why you take them.
- We encourage you to share the CMR summary materials with your doctor(s).
- Click here to see an example of the CMR letter.
- Ongoing targeted medication reviews (TMR)
- At least once every 3 months, your medicines will be reviewed.
- If a potential problem is detected, you or your doctor(s) may be contacted by telephone or mail to review.
For information about the MTM Program or to see if you qualify, you can call AlohaCare Member Services at 808-973-6935 or toll-free at 1-866-973-6395; October 1 to March 31, 8 a.m. to 8 p.m., 7 days a week; April 1 to September 30, 8 a.m. to 8 p.m., Monday through Friday. TTY/TDD users call 1-877-447-5990.
AlohaCare wants you to have every opportunity to participate in this program when and where convenient for you. That is why we work with IngenioRx and other health organizations to provide MTM services on our behalf. One of these organizations may contact you about completing a Comprehensive Medication Review (CMR) or other MTM services.
Partner organizations: IngenioRx Clinical Pharmacy Care Center - (1-833-404-2161), OutcomesMTM - Patient Engagement Team
*Additional partner organizations may be added if they meet our rigorous requirements to services our members.