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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:

  • Alzheimer’s disease
  • Bone disease-arthritis (including osteoporosis, osteoarthritis, and rheumatoid arthritis)
  • Chronic Heart Failure (CHF)
  • Diabetes
  • Dyslipidemia
  • End-Stage Renal Disease (ESRD)
  • Human immunodeficiency virus/ acquired immunodeficiency syndrome (HIV/AIDS)
  • Hypertension
  • Mental health (including depression, schizophrenia, bipolar disorder, and other chronic/disabling mental health conditions) and
  • Respiratory disease (including asthma, chronic obstructive pulmonary disease (COPD), and other chronic lung disorders)

And –

  • Be on at least eight covered Part D chronic medications

And –

  • Be likely to incur an annual Part D drug cost of $1,276 or greater

Or –

  • Are in a Drug Management Program to encourage safe use of medications, including those for pain management

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 with all your medications.

For more information about your eligibility or to schedule an appointment for a medication review with one of our Clinical Pharmacists, call us at 1-844-450-5721 (TTY 711), Monday to Thursday, 9am–6:30pm, and Friday, 9am–5:30pm. Within 14 days of completing your medication review, you will receive a summary of what was discussed, including action items and a list of your medications, cost savings opportunities, and potential drug interactions.
The results may be sent to your doctor for their review.

Coverage is provided by Healthfirst Health Plan, Inc., Healthfirst PHSP, Inc., and/or Healthfirst Insurance Company, Inc. (together, “Healthfirst”). Plans contain exclusions and limitations.

ATENCIÓN: Dispone de servicios de asistencia lingüística y otras ayudas, gratis. Llame al 1-866-305-0408 (TTY: 1-888-867-4132).
请注意：您可以免费获得语言协助服务和其他辅助服务。请致电 1-866-305-0408 (TTY: 1‑888‑542‑3821)。

Last update January 2, 2026 @ 12:07 pm

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