Medicare Members: Protect yourself against Medicare fraud and Identify theft! The U.S. Department of Health and Human Services Office of Inspector General is alerting the public about a fraud scheme involving genetic testing. Learn how to protect yourself.
Medication Therapy Management Program | Wellcare Nebraska
Medication Therapy Management Program (MTMP)
Our plan has programs that help you manage your Part D medications in special situations. For example, you may have several complex medical conditions. If so, you may need to take many prescription drugs to treat those conditions. You also could have high drug costs.
A team of pharmacists and doctors developed a program to help members like you with your healthcare. This is called the Medication Therapy Management Program, or MTMP. Our MTMP pharmacists help our members and their doctors choose the drugs that work best to treat their medical conditions. They also help identify possible errors and improve medication adherence.
The program is not a benefit. It’s an extra service that is voluntary and at no cost to eligible members who:
- Have three or more of these medical conditions:
- Chronic Obstructive Pulmonary Disease (COPD)
- End-Stage Renal Disease (ESRD)
- High cholesterol (hyperlipidemia)
- Take eight or more chronic or maintenance Part D drugs
- Spend more than $4,696 each year on drugs
If you meet the above criteria, we enroll you in our program automatically. From there, one of our MTMP pharmacists reviews your medication history and sends you a welcome letter. The letter describes any potential medication related problems found and invites you to call for a full review. We may also reach out to you in other ways about your medications. If you do not want us to contact you, just tell us. We will remove you from the program.
If you want to continue, one of our pharmacists or pharmacy interns, under the direct supervision of a pharmacist, will connect you with the following services. The goal is to help you reach the best results to fit your needs:
- Annual Comprehensive Medication Review (CMR). Conducted by phone or face-to-face, a CMR creates a collection of all of your medication-related information. The pharmacist will go over your medications and medical conditions. The CMR takes approximately 45 minutes and addresses any of your concerns.
- Personal Medication List (PML). A list of all your prescriptions and over-the-counter medications discussed during the review. The PML can be updated as needed. Sample PML (PDF)
- Medication Action Plan (MAP). One of our MTMP pharmacists creates your MAP. It helps you follow steps in taking medications to reach your health goals.
- We print your PML and MAP and either mail or hand-deliver them to you within 14 days of your CMR.
- Quarterly Targeted Medication Reviews (TMR). TMRs identify potential safety concerns for you. They include drugs that people over age 65 should generally not take, or drug therapies that you should be on based on your conditions but aren’t. If our MTMP pharmacists find issues, we send you a letter with ways to help improve your medication use. We may also fax any issues to your doctor.
If you want to participate in our MTMP but are unable to, you can authorize someone on your behalf. Our MTMP pharmacist who helps you may work with other team members if you need more services to help you reach your health goals.
See 2022 for Plan information