What is the Medication Therapy Management Program?
The Medication Therapy Management (MTM) Program is a part of Cigna Medicare Part D Prescription Drug Plans and Cigna Medicare Advantage Plans (Part C) with prescription drug coverage.
MTM can help find any possible errors and gaps in your care by:
- Lowering the risk of medication errors, especially if you have chronic conditions, take many medications, or see multiple doctors
- Giving information on proven medical practices to help you and your doctor decide the most effective treatment
- Helping you understand your condition and medications, so you can take an active role in taking care of your health
You may qualify for program assistance if:
You have at least 3 of the medical conditions below:
- Chronic heart failure
- Bone disease (osteoporosis)
You should take at least 7 drugs from selected classes:
- Oral hypoglycemic
- Angiotensin-converting-enzyme (ace) inhibitors
- Angiotensin ii receptor blockers (arbs)
- Beta blockers
- Alpha blockers
- Calcium channel blockers
- Other metabolic bone disease agents.
Your prescriptions for the last 3 months cost more than one-fourth of the yearly cost level. The Centers for Medicare & Medicaid Services (CMS) set a cost level each year. The 2021 cost level is $4,376.
Cigna Medicare customers who qualify for the MTM Program are automatically enrolled1 and sent a welcome packet in the mail.
Based on the guidelines above, all chosen customers will be offered a full medication review (CMR) by a Cigna Medicare clinical pharmacist at least yearly. The CMR is an interactive session with 1 of our Cigna Medicare clinical pharmacists to talk about all medications, such as:
- Over-the-counter (OTC) medications
- Herbal therapies
- Dietary supplements
After the medication review, you'll get an individualized letter in the mail. Each letter has a personal medication record of all medications discussed and a plan of action, if needed. Your prescriber may also get a letter after your CMR with possible interventions to solve medication-related problems or other ways to optimize medication use. We automatically give you a targeted medication review each quarter for eligible customers and mail their prescribers a letter with intervention opportunities.
Getting involved in the MTM Program may help improve your health and lower your risk for medication reactions, hospitalization, and emergency room visits. Depending on your diagnosis, it may help improve your cholesterol and blood sugar levels, and lower your risk of heart attack.
There is no extra cost for this program. While it’s not seen as a Medicare benefit, the MTM Program is part of the plan you select for coverage.
What if I have questions?
If you have questions or need more information, please call the Cigna Medicare MTM Program toll-free:
Medicare Advantage Plans (Part C)
1 (800) 625-9432 (TTY 711)
Medicare Part D Prescription Drug Plans
1 (877) 714-6422 (TTY 711)
Appointments are available Monday - Friday, 8 am - 5 pm ET. For questions about health plan benefits, coverage issues, or claims, please contact us.
1Unless you opt-out of enrolling in the program.
The Medication Therapy Management (MTM) Program is a component of Cigna Medicare prescription drug plans and should not be considered a Medicare benefit. MTM is neither offered nor guaranteed under our contract with the Medicare program and is not subject to the Medicare appeals process.