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What is Medication Therapy Management?

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 risk for misuse or abuse of an opioid or a frequently abused drug under the Drug Management Program (DMP). The Medication Therapy Management Program is utilized to help our members manage medications and ensure they are receiving medications according to their medical conditions, identify any possible medication interactions, duplication of therapy, and review drug dosages according to the appropriate prescribing standards.

Please note that the Medication Therapy Management Program (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 are in a DMP to help with opioid use and/or meet all of the following three criteria:

  • Have three or more chronic medical conditions, such as
    • Chronic Obstructive Pulmonary Disease (COPD)
    • Chronic Heart Failure (CHF)
    • Rheumatoid Arthritis
    • Alzheimer's Disease
    • Bipolar Disorder
  • Take eight or more Medicare Part D covered drugs
  • Expect to spend more than a specified amount on covered Medicare Part D prescriptions:
    • $4,935 or more in 2023
    • $5,330 or more in 2024

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.