2017 EmblemHealth Medication Therapy Management
(MTM) Program

The MTM Program is a free service for EmblemHealth Medicare plan members with a Part D prescription drug coverage who have certain health conditions and who take seven or more chronic medications. The MTM Program helps you and your doctor make sure that your medicines are working to improve your health. A pharmacist or a health care provider will review your prescription medicines, over-the-counter drugs, and any herbal supplements you may take to make sure they are safe and working for you. Our health care professionals will help you understand your medications and how to take them and answer any questions and concerns you may have.

  • How do I qualify for the MTM program?
    To participate in the MTM program, you must be eligible. If you qualify, we will automatically enroll you – at no additional cost to you. The MTM Program is a voluntary program.
  • Who is eligible for the MTM Program?
    You may qualify for the MTM Program if all of the following apply to you:
    1. You have an EmblemHealth Medicare plan that includes Part D prescription drug coverage.
    2. You use at least seven or more medications for chronic conditions.
    3. You have at least three of the five following conditions:
    • Rheumatoid arthritis
    • Chronic heart failure
    • Diabetes
    • High cholesterol
    • Chronic obstructive pulmonary disease
    4. You spend $3,919 or more per year on chronic medications.
  • What will you get if you are eligible for the program?
    If you are eligible you will:
    • Get a welcome letter that tells you how to get started.
    • Be contacted to have a phone appointment to receive a full medication review with an EmblemHealth pharmacist or health care provider. The review can take up to 30 minutes or longer depending on your medication profile. During this call, the pharmacist or health care professional will review your prescription, over-the-counter medicines and any herbal supplements you may take to make sure they are safe and working for you. We want to be sure you understand your medicines and how to take them and will answer any questions and concerns you may have.
    • Receive a personal medication list, which will be mailed to you after the call. Your personal medication list includes all of the medicines you take for your chronic conditions and explains how and why you take them. You will also receive a medication action plan to remind you about what you talked about during the call and what you need to do.
    • Have your medicines reviewed for any medication-related issue(s) every quarter. If there are any issues, your doctor will get a letter explaining the issue(s).

  • How do I qualify for the MTM program?
    To find out more about the MTM Program or to see if you qualify, you can call EmblemHealth Pharmacy Services at 1-888-447-0321, Monday to Friday, 9 am to 5 pm. If you have a speech or hearing impairment and use a TTY/TDD, please call 711, Monday to Friday, 9 am to 5 pm.

    Although the MTM program is a special program provided to Medicare members, it is not considered a benefit.