Medication Therapy Management (MTM) is a patient-centered and comprehensive approach to help members understand their medications and use them safely. The Medication Therapy Management (MTM) Program is not a covered benefit of Viva Medicare. Rather, it is a program available, at no additional cost, to members who meet certain criteria. You will be automatically enrolled in the Medication Therapy Management Program if you meet ALL of the following three (3) criteria:
2021 MTM Program Criteria
Take eight (8) or more drugs from the following specific Part D drug classes:
- Alpha Blockers
- angiotensin-converting enzyme (ACE) inhibitors
- angiotensin II receptor blockers (ARBs)
- beta blockers
- calcium channel blockers
- oral hypoglycemics
- calcitonin salmon nasal
AND Have three (3) or more of the following long-term health conditions:
- Chronic Heart Failure (CHF)
AND Have an anticipated annual drug spend of at least $4,376 for calendar year 2021 or $4,255 for calendar year 2020.
The Viva Medicare MTM Program offers a Comprehensive Medication Review (CMR) for all eligible members either face-to-face or over the phone. Members who meet eligibility requirements will be automatically enrolled and sent an invitation letter welcoming them to the program. After receiving the invitation letter, you will be contacted by a partnering local pharmacy, an MTM call center, or a Viva Medicare pharmacist or other qualified providers to schedule your medication review. A CMR takes about 30 minutes and is usually offered once each year. A specially trained pharmacist or other qualified provider will review your medication history, including prescription and over-the-counter medications, and identify and resolve any medication issues. Confirmed medication-related problems and recommendations may be communicated to your prescriber. Upon completion of the CMR, you will be mailed a Medication Action Plan that provides steps you should take to help you get the best results from your medications and a Personal Medication List that will help you keep track of your medications and how to use them the right way. You may obtain a blank copy of the Personal Medication List by clicking here.
You may choose to disenroll from the MTM Program any time during the year or you may decline individual services without having to disenroll from the program. In addition to the CMR, all MTM eligible members will also receive a Targeted Medication Review (TMR). The pharmacy claims of all members who qualify for MTM will be reviewed every three months to identify any new or persistent drug therapy problems, such as the presence of potential safety problems and/or gaps in care involving adherence to chronic medications and omissions in care. If the TMR analysis identifies any issues, then follow-up intervention opportunities are communicated to your prescriber(s) via fax or mail.
For more information on Viva Health Medicare MTM Program, please contact our member services department at 1-800-633-1542 or 205-918-2067, TTY users call 711. The hours are Monday-Friday, 8 am - 8 pm. From October 1st through March 31st, seven days a week, 8 am - 8 pm.