The Moda Health Medication Therapy Management Program (MTM)

We offer a free Medication Therapy Management (MTM) program for members of our Prescription Drug plans. You are eligible to participate in this program if you meet all of the following criteria:

  • Have two or more of the following chronic conditions:
    • Diabetes
    • High Cholesterol
    • High Blood Pressure
    • Depression
    • Asthma
    • Chronic Obstructive Pulmonary Disease (COPD)
    • Osteoarthritis
    • Human Immunodeficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS)
    • Chronic Heart Failure (CHF)
  • Take five or more medications
  • Have drug costs that total $3,919 or more annually

We use this program to make sure that our members get the optimum results from the medications they use by improving medication use and reducing the risk of side effects. This program is not considered a benefit as it is free to those who are eligible to participate.

We take a look at your drug information each quarter. If it is determined that you meet the criteria indicated above, we will automatically enroll you in the program and send you a notice inviting you to speak with one of our qualified pharmacists to discuss the medications you are taking.

If you choose to participate in this discussion, we will schedule a call with you for a comprehensive medication review (CMR), which usually takes between 30 to 60 minutes. The CMR includes a medication action plan based on your discussion with our qualified pharmacist. It also includes your personal medication list, which is documentation of all of the medications you are taking. To view a blank copy of the medication action plan and personal medication list format, click here. After your CMR has been completed, we will mail a copy to you for your records. It is recommended you take your standardized medication action plan and personal mediation list to your medical appointments. This summary can serve as a valuable tool to share information among the providers you see for your care and help reduce dangerous drug interactions or duplications in medication treatments.

We also perform targeted medication reviews (TMRs) as part of this program. This means we review the specific medications you are taking to identify any opportunities for improvement in terms of safety or adjustment to your medication regimen. If such opportunities are identified, we will notify the provider who prescribed you these medications so they can review your information and make any modifications to your treatment as necessary.

If you would like additional information about our MTM program please contact customer service.

Last updated October 1, 2016
Y0115_WEB_2017A Approved

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