Alignment Health Plan has a free voluntary program for members who have multiple medical conditions, take many prescription drugs, have high drug costs, and/or are determined to be at highest risk of an adverse event or overdose related to an opioid or a frequently abused drug under the Drug Management Program (DMP). The Medication Therapy Management Program (MTMP) helps our members manage medications, ensures they are receiving medications according to their medical conditions and at the appropriate prescribing standards and identifies possible medication interactions and duplication of therapy.

Please note that the MTMP is not considered a benefit. It is available to you at no cost if you qualify. You will be automatically enrolled in this program if you at risk of an opioid adverse event or overdose related to an opioid or a frequently abused drug under the DMP and/or meet all of the following three criteria:

1. Have three or more chronic medical conditions, such as:
   • Alzheimer's Disease
   • Bone Disease - 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 (depression, schizophrenia, bipolar disorder, and other chronic/disabling mental health conditions)
   • Respiratory Disease (asthma, chronic obstructive pulmonary disease (COPD), and other chronic lung disorders)
2. Take eight or more Medicare Part D covered drugs
3. Expect to spend more than a specified amount on covered Medicare Part D prescriptions:
   • $1,623 or more in 2025
   • $1,276 or more in 2026

The MTMP offers a comprehensive review of all your medications and discusses with you over the phone on how to better manage your conditions with drug therapy. If you are eligible for this program, you will be notified by mail. We will then contact you by telephone to perform this service. Each session takes about 30-40 minutes. After the telephone session, we will send you a Medication List and a Recommended To-Do List which are summaries of what we’ve talked about. We will also perform Targeted Medication Review quarterly and may contact you or your doctor directly if there are questions about your medications. In addition, you will receive information on the safe disposal of prescription medication that are controlled substances.

Click on the link below for a sample of the Medication List:

Medication Therapy Management Program: Medication List

If you would like additional information about the program, please call our Member Services Department at 1-866-634-2247 (TTY 711), 8:00 a.m. to 8:00 p.m., 7 days a week (except Thanksgiving and Christmas) from October 1 through March 31, and Monday to Friday (except holidays) from April 1 through September 30. Calls to this number are free. Member Services also has free language interpreter services available for non-English speakers. TTY requires special telephone equipment and is only for people who have difficulties with hearing or speaking.