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Medication Therapy Management Program
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Health Choice Generations Medication Therapy Management Program

What is the Medication Therapy Management Program (MTMP)?

The MTMP program is designed to improve the way Health Choice Generations members take their medication. The plan works with doctors and pharmacists to make sure members get the most medically appropriate, safe and cost-effective medications.

This process has two goals:

  1. To get you the prescriptions you need, even if they are not on the list of drugs the plan covers.
  2. To protect you from drug interactions that might harm you.
MTM programs can help identify potential errors and gaps in your medical care; help reduce the risk of medication errors; provide current information on medical practices to help you and your doctor decide the best treatment; and help you understand your condition and medications so you can take an active role in managing your healthcare.

Generally, people who are enrolled in an MTM program take multiple medications; have chronic illnesses or diseases; or have high drug costs.

The voluntary program is free to all Health Choice Generations members who meet eligibility requirements. It is not a benefit of Health Choice Generations plan.

How do I enroll and what happens in the MTM program?

Health Choice Generations members will be sent a questionnaire to fill out and return or they can call Member Services to ask about the program or enroll. Members could also receive a call from a Health Choice Generations Case Management nurse. If a member is contacted, we hope you will join the MTM program.

The information will be sent to the Health Choice Generations Medical Management department who will review the medical information and medications take by the member for interactions, appropriateness and compliance. This review could take up to X days/weeks so please do not be alarmed if you do not hear from a Health Choice Generations representative right away. The Medical Management team will then contact the member and enroll them into the MTM program.

If Health Choice Generations identities any emergent or urgent issues they will be discussed with the member and/or the member's physician for immediate action. Follow-up calls will be scheduled as needed with a call at least every 6 months.

You will be enrolled through the calendar year and can be involved every year that you meet the eligibility requirements.

Long term care (LTC) members who meet eligibility will be sent a letter without a questionnaire and auto-enrolled into the MTM program. The LTC members will be sent information in the mail along with an 800 number to call if they have any questions about their medications or the information that was sent to them.

How would a member disenroll?

A member or a member's caregiver or physician may disenroll from the MTM program at anytime. This program is through Express Scripts toll free at 1-800-305-7922 Monday through Friday 8 am to 5 pm CST (TTY/TTD user should call 1-800-735-2905) to schedule an appointment.