Medication Therapy Management (MTM) Program

The Healthfirst Medication Therapy Management (MTM) program is an in-depth, one-on-one review of all your medications (prescription, over-the-counter, herbal, and nutritional).

The MTM program is not a benefit, but rather an extra service offered at no additional cost to eligible participants.
The goal is to help you understand your medications and use them safely.

You’ll be contacted by mail and phone if you’re eligible to participate in this program.

Medicare Advantage Plans

To be eligible, you must have at least three of the following specific chronic diseases:

  • Bone Disease, Arthritis, Osteoarthritis
  • Chronic Heart Failure (CHF)
  • Chronic Obstructive Pulmonary Disease (COPD)
  • Dyslipidemia
  • Hypertension

And –

  • Be on at least eight covered Part D medications
  • Be likely to incur an annual Part D drug cost of $4,696

MTM Services Include:

  • A phone consultation with a licensed pharmacist to complete a Comprehensive Medication Review (CMR). This will take about 30 to 60 minutes, and they’ll answer any questions you have. (A CMR is offered once each year, if you qualify.)
  • Medication Action Plan (MAP).
  • Medication recommendations may be sent to your provider from the MTM pharmacist, also known as Targeted Medication Review (TMR).
  • Personal medication list that lists all your medications.

For more information about your eligibility or to schedule an appointment for the MTM program, call CSS Health at 1-866-978-8462 (TTY 711), Monday through Thursday; 9am–7pm. Friday 9am–5pm, and Saturday 9am–1pm. We can send your Medication Action Plan, personal medication list, and recommendations to your provider within two weeks of contacting us.

Coverage is provided by Healthfirst Health Plan, Inc. or Healthfirst Insurance Company, Inc. Plans contain exclusions and limitations.

Healthfirst Health Plan, Inc. and Healthfirst Insurance Company, Inc. offer HMO and PPO plans that contract with the Federal Government. Healthfirst Health Plan, Inc. has a contract with New York State Medicaid for its Dual-Eligible Special Needs Plans. Enrollment in Healthfirst Medicare Plan depends on contract renewal.

Healthfirst Medicare Plan, Inc. complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-866-305-0408 (TTY 1-888-867-4132). 注意:如果您使用繁體中文,您可以免費獲得語言援助服務。請致電 1-866-305-0408 (TTY 1-888-542-3821).




Last update July 29, 2022 @ 8:00 am

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