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Medicare Medication Therapy
Management Program

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Medication Therapy Management
Program - 2027

Better therapeutic outcomes for members with multiple conditions

Our Medication Therapy Management Program (MTMP) is focused on improving therapeutic outcomes for Medicare Part D members. To qualify for MTMP, a member must meet all the following criteria:

  • Members must have filled eight (8) or more chronic Part D medications; and
  • Members must have at least three (3) of the following ten chronic conditions 
    • Alzheimer’s Disease
    • Respiratory Disease (including Asthma, Chronic Obstructive Pulmonary Disease (COPD), and other chronic lung disorders)
    • Congestive Heart Failure (CHF)
    • Mental Health (including Depression, Schizophrenia, Bipolar Disorder, and other chronic/disabling mental health conditions)
    • Diabetes
    • High Blood Pressure
    • High Cholesterol
    • Bone Disease-Arthritis (including Osteoporosis, Osteoarthritis, and Rheumatoid Arthritis)
    • End-Stage Renal Disease (ESRD)
    • HIV/AIDS
  • Members must be likely to incur 2027 annual costs of $1,340 for all covered chronic Part D medications.

            OR

  • Are in a Drug Management Program to help better manage and safely use medications such as opioids and benzodiazepines

Do you meet all the criteria above? MTMP will help you learn about how to manage the various medications you need to stay healthy.

The success of our MTMP is built upon our proven experience using a wide range of services designed to help members with multiple conditions by:

  • Ensuring they take their medications correctly
  • Improving medication adherence
  • Detecting potentially harmful medication uses or combinations of medications
  • Educating members and health care providers

Our programs are evidence-based and can integrate both pharmacy and medical data, when available, and are built upon multiple measures that demonstrate positive clinical outcomes for members like you. Pharmacists, physicians and PhDs develop, manage and evaluate the programs for effectiveness.

One-on-one consultations between our clinicians and members are also an important part of our MTMP. Such consultations ensure that members are taking their medications as prescribed by their health care provider.

 

Comprehensive Medication Review (CMR)

The Centers for Medicare & Medicaid Services (CMS) requires all Part D sponsors to offer an interactive, person-to-person comprehensive medication review (CMR) to all MTM-eligible members as part of MTMP. If you meet the criteria outlined above, you will receive an MTMP Enrollment Mailer or phone call offering our CMR services. A CMR is a review of a member’s medications (including prescription, over-the-counter (OTC), herbal therapies and dietary supplements), which is intended to aid in assessing medication therapy as well as optimizing outcomes. Also, MTMP-eligible members will be included in quarterly targeted medication review (TMR) programs that assess medication profiles for duplicate therapy or drug-disease interaction in which members’ prescribers may receive a member-specific report.  

The CMR includes three components:

  1. Review of medications to assess medication use and identify medication-related problems. This may be conducted person-to-person or "behind the scenes" by a qualified provider and/or using computerized, clinical algorithms.
  2. An interactive, person-to-person consultation performed by a qualified provider at least annually to all MTM-eligible members.
  3. An individualized, written summary of the consultation for the member, including but not limited to, a medication list, reconciled medication list, and recommended to-do list for monitoring, education, or self-management.

View or download a sample copy of our MTMP Enrollment Mailer

View or download a copy of the Medication List

View or download a copy of the Recommended To-Do List

 

Do you have unused expired medications and are looking for a safe way to dispose of them?  Before you throw them away, here are some things you should know.

Here is how to safely dispose of unused or expired medications before they do harm:

For safety reasons, dispose of unused medications as soon as possible. Here are a few tips for safe disposal:

  • Find a nearby pharmacy or other local resource with a medication take back service. 
  • If you cannot get to a drug take back location promptly, or there is none near you:
    • Mix the unused supply with an undesirable substance such as dirt or coffee grounds.
    • Put the mixture into a disposable container with a lid, such as an empty margarine tub, or into a sealable bag, then place the sealed container in your trash. 
    • Make sure to conceal or remove any personal information, including Rx number, on the empty containers by covering it with black permanent marker or duct tape, or by scratching it off to protect your privacy.
    • Place both the sealed container with the mixture and the empty drug containers in the trash. 
    • Only flush approved unused or expired medications down the toilet only if indicated on the label, patient information, or no other disposal options are available. 

More information on the safe disposal of medications can be found on the United States Department of Health and Human Services website: https://www.hhs.gov/opioids/prevention/safely-dispose-drugs/index.html

Please contact us if you would like more information about the Mass General Brigham Health Plan MTM Program or if you do not want to participate. Our number is 1-855-833-3668 (TTY: 711) for Medicare Advantage members or 1-888-816-6000 (TTY: 711) for OneCare and SCO members.

We are available from 8 a.m. to 8 p.m. EST, Monday through Sunday, October 1– March 31; and 8 a.m. to 8 p.m. EST, Monday through Friday, April 1– September 30.

You may also contact the OptumRx MTM Department at 1-866-352-5305. (TTY users dial 711), Monday - Friday, 9 a.m. to 9 p.m. EST.

These programs are provided at no additional cost as part of your coverage and are not considered a benefit.

 

Medication Therapy Management
Program - 2026

The Mass General Brigham Health Plan Medication Therapy Management (MTM) Program is all about you and your health. The MTM Program helps you get the most out of your medications by:

  • Preventing or reducing drug-related risks
  • Supporting good lifestyle habits
  • Providing information for safe medication disposal options

Frequently Asked Questions

 

You will be enrolled in the Mass General Brigham Health Plan MTM Program if you meet all of the following criteria:

1. You have at least three (3) or more of these conditions: 

  • Alzheimer’s disease
  • Bone disease-arthritis (including osteoporosis, osteoarthritis, and rheumatoid arthritis)
  • Chronic congestive heart failure (CHF)
  • Diabetes
  • End Stage Renal Disease (ESRD)
  • High Blood Pressure (Hypertension)
  • High Cholesterol (Dyslipidemia)
  • HIV/AIDS
  • Mental Health (including depression, schizophrenia, bipolar disorder, and other chronic/disabling mental health disorders)
  • Respiratory disease (including asthma, chronic obstructive pulmonary disease (COPD), and other chronic lung disorders)

2. You take eight (8) or more routine Part D medications covered by your plan
3. You are likely to spend more than $1,276 in Part D prescription drug costs in 2026

OR

4. Are in a Drug Management Program to help better manage and safely use medications such as opioids and benzodiazepines

Your participation in the MTM Program is voluntary and does not affect your coverage. This is not a plan benefit and is open only to those who qualify. There is no extra cost to you for the MTM Program.

If you qualify, we will mail you an Enrollment letter. You may also receive a call to set up your one-on-one medication review.


In the MTM Program, you will receive the following services from a health care provider:

  • Comprehensive medication review (CMR)
  • Targeted medication review (TMR)


The comprehensive medication review is completed with a health care provider in person or over the phone. This review is a discussion that includes all your medications:

  • Prescriptions
  • Over-the-counter (OTC)
  • Herbal therapies
  • Dietary supplements

This review usually takes 20 minutes or less to complete. During the review, you may ask any questions about your medications or health conditions. The health care provider may offer ways to help you manage your health and get the most out of your medications. If more information is needed, the health care provider may contact your prescriber.

After your review, you will receive a summary of what was discussed. The summary will include the following:

  • Recommended To-Do List. Your to-do list may include suggestions for you and your prescriber to discuss during your next visit.
  • Medication List..This is a list of all the medications discussed during your review. You can keep this list and share it with your prescribers and/or caregivers.

If you are eligible for the MTM Program, you will receive an Enrollment letter through the mail. You may also receive a phone call. The enrollment letter will provide information on how to set up your comprehensive medication review with a pharmacist. You can schedule it by completing and sending back the enclosed form, or calling the toll-free number provided.

A health care provider may also call you to complete your review over the phone. When they call, you can schedule your review at a time that is best for you.
 

  • Trusted MTM Program partner: You may receive a call from the OptumRx MTM Team to complete this service.


Different prescribers may write prescriptions for you without knowing all the medications you take. For that reason, the MTM Program health care provider will:

  • Review all your medications
  • Discuss how your medications may affect each other
  • Identify any side effects from your medications
  • Help you reduce your prescription drug costs

 

By completing the medication review with a health care provider, you will:

  • Understand how to safely take your medications
  • Get answers to any questions you may have about your medications or health conditions
  • Review ways to help you save money on your drug costs
  • Receive a Recommended To-Do List and Medication List for your records and to share with your prescribers and/or caregivers

The targeted medication review is completed by a health care provider who reviews your medications at least once every three months. With this review, we mail, fax, or call your prescriber with suggestions about prescription drugs that may be safer or work better for you. As always, your prescriber will decide whether to consider our suggestions. Your prescription drugs will not change unless you and your prescriber decide to change them. We may also contact you by mail or phone with suggestions about your medications.

Please contact us if you would like more information about the Mass General Brigham Health Plan MTM Program or if you do not want to participate. Our number is 1-855-833-3668 (TTY: 711) for Medicare Advantage members or 1-888-816-6000 (TTY: 711) for OneCare and SCO members.

We are available from 8 a.m. to 8 p.m. EST, Monday through Sunday, October 1– March 31; and 8 a.m. to 8 p.m. EST, Monday through Friday, April 1– September 30.
 

The Mass General Brigham Health Plan MTM Program is dedicated to providing you with information about safe medication disposal. Medications that are safe for you may not be safe for someone else. Unneeded medications should be disposed of as soon as possible. You can discard your unneeded medications through a local safe disposal program or at home for some medications. 

Find a nearby pharmacy or other local resource with a medication take back service.

Safe at-home medication disposal:

You can safely dispose of many medications through the trash or by flushing them down the toilet. Visit the United States Department of Health and Human Services (HHS) website first to learn what medications are safe to dispose of at home: https://www.hhs.gov/opioids/prevention/safely-dispose-drugs/index.html

Steps for medication disposal in the trash:

  • Mix the unused supply with an undesirable substance such as dirt or coffee grounds.
  • Put the mixture into a disposable container with a lid, such as an empty margarine tub, or into a sealable bag, then place the sealed container in your trash.
  • Make sure to conceal or remove any personal information, including Rx number, on the empty containers by covering it with black permanent marker or duct tape, or by scratching it off to protect your privacy.
  • Place both the sealed container with the mixture and the empty drug containers in the trash.
  • Only flush approved unused or expired medications down the toilet only if indicated on the label, patient information, or no other disposal options are available.

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Mass General Brigham Health Plan is an HMO-POS/PPO organization with a Medicare contract. Enrollment in Mass General Brigham Health Plan depends on contract renewal. Other providers/pharmacies are included in our network.
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Last updated: 10/1/2025

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