Medication Therapy Management - Community Health Plan of Washington - Medicare Advantage

What is the Medication Therapy Management (MTM) Program?

The Medication Therapy Management (MTM) Program is a service for members with multiple health conditions and who take multiple medications. The program helps make sure you are taking the correct medications and that those medications are improving your health.

You must qualify for the MTM program. Check the eligibility requirements below. If you qualify, you will be automatically enrolled in the program. This service is provided at no additional cost to you. You may choose not to participate in the program, but we recommend that you make use of this free service.

The MTM program is offered through a partnership between CHPW Medicare Advantage and SinfoníaRx. The MTM program through SinfoníaRx helps you and your doctor make sure that your  medications are working to improve your health. Learn more by visiting the Sinfonia Rx website, or by calling 1-844-866-3730.

The MTM program is not considered a part of the plan’s benefits. Read our MTM policy and procedure for more information.

Who is eligible for the MTM program?

In order to qualify for the MTM program, you must meet all of the following criteria.

1. You have three or more chronic health problems. These may include:

  • Asthma
  • Chronic Heart Failure (CHF)
  • Chronic Obstructive Pulmonary Disease (COPD)
  • Depression
  • Diabetes
  • End-Stage Renal Disease (ESRD)
  • High blood fat levels
  • High blood pressure
  • Osteoporosis

2. You take seven or more daily medicines covered by Medicare Part D.
3. You spend $4,044 or more per year on Part D covered medications.

How does the MTM Program help you?

If you qualify for the MTM Program, you will be contacted and have the chance to speak with a highly-trained pharmacist or a pharmacist intern who is under the direct guidance of a pharmacist. During that call, the pharmacist or pharmacy intern will complete a comprehensive medication review 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.

What will you receive?

If you qualify for the MTM Program, you will receive:

  1. Welcome letter that tells you how to get started.
  2. Full medication review:
  • You will have the chance to review your medicines with a highly-trained pharmacist or a pharmacist intern under the direct guidance of a pharmacist each year. This review will take about 20-30 minutes. We will schedule the call at a convenient time for you. During this call, you can discuss any issues with your medicines.
  • After you complete the full medication review, you will receive a summary by mail. The summary includes a medication action plan with space for you to take notes or write down any follow-up questions.
  • You will also receive a Medication Review letter, that lists all of the medicines you take and the reasons why you take them.
  • Here is an example of the Medication Review letter.
  1. Ongoing targeted medication reviews:
  • At least once every three months, a pharmacist reviews your medications. They will notify you or your doctor about any changes in medication to consider.
  • You may get a letter or a phone call for this review.

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